Brain and Spine Work Assessment and Therapy Center

Primary specialty

SpecialistTaxonomy code 174400000X

License

PT4387 Issued in FL

Legal business name

BRAIN AND SPINE WORK ASSESSMENT AND THERAPY CENTER

Practice address

2101 Northside Dr
Suite 502
Panama City, FL 32405-3685

Phone

(850) 913-7040

Fax

(850) 913-0290

NPI assigned

May 21, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Ron Samuelian

Title

Ceo

Phone

(850) 747-0400

Specialties & licenses 1

Addresses

Other identifiers 1

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1992913040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2101 NORTHSIDE DR",
            "address_2": "SUITE 502",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324053685",
            "telephone_number": "850-913-7040",
            "fax_number": "850-913-0290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2101 NORTHSIDE DR",
            "address_2": "SUITE 502",
            "city": "PANAMA CITY",
            "state": "FL",
            "postal_code": "324053685",
            "telephone_number": "850-913-7040",
            "fax_number": "850-913-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRAIN AND SPINE WORK ASSESSMENT AND THERAPY CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SAMUELIAN",
        "authorized_official_first_name": "RON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "850-747-0400",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "FL",
            "license": "PT4387",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS SUPER Y GROUP #",
            "identifier": "Y924S",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Susan Overton Bozarth
• BPSG L.L.C.
• Laura Rizzo Bracey, ARNP
• Amanda A Bragdon
• Brain and Spine LLC
• Kristen Nicole Bramlet, PA
• Branch Medical Clinic Panama City
• Eric Alan Branch, MD
• Josh Brannon, LMT
• Gayle Mucelli Branson, PHARMD

• Specialist in Panama City, FL
• Providers in Panama City, FL by specialty
• Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.