MR. BRANT LOGAN NICKENS (NPI# 1417560707) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417560707 |
| Entity Type | Individual |
| Full Name | MR. BRANT LOGAN NICKENS |
| Credential | PT, DPT |
| Practice Address |
809 Lamont St and Veterans Way Johnson City TN 37604 |
| Mailing Address |
1616 Seminole Dr Apt 101 Johnson City TN 37604-7039 |
| Practice Telephone | 4239261171 |
| Mailing Telephone | 8652917390 |
| Enumeration Date | 2020-08-26 |
| Last Update Date | 2020-08-26 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251X0800X |
Physical Therapist Specialization: Orthopedic |
12971 | TN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
809 LAMONT ST AND VETERANS WAY |
| City | JOHNSON CITY |
| State | TN |
| Zip Code | 37604 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952911562 | David Sandlin Hobbs | Pharmacist | Lamont St &, Veterans Way, Johnson City, Tn 37604, Johnson City, TN 37604 | 2020-08-07 |
| 1528688272 | Whitney Marie Ward | Physical Therapist | Lamont Street and Veterans Way, Johnson City, TN 37604 | 2020-04-23 |
| 1861050015 | Akesh Thomas | Student in an Organized Health Care Education/Training Program | Johnson City Medical Center, 400 N State of Franklin Rd, Johnson City, TN 37604 | 2019-06-03 |
| 1336629021 | Medical Education Assistance Corporation | Clinic/Center | 820 W Market St, Johnson City, TN 37604 | 2018-08-21 |
| 1093208951 | Lauren Tiffany Hayden | Physician Assistant | 403 N State of Franklin Rd Woodridge Hospital, Johnson City, TN 37604 | 2018-06-14 |
| 1174014450 | Jerica Moore | Specialist/Technologist | 1041 Hamiltion Place Dr., Johnson City, TN 37604 | 2018-05-23 |
| 1053809442 | Syed Ghazanfar Hasan | Student in an Organized Health Care Education/Training Program | Etsu Psychiatry and Behavioral Sciences Department, 1276 Gilbreath Dr., Johnson City, TN 37604 | 2018-05-01 |
| 1699262485 | Sonia Kumari Oad | Student in an Organized Health Care Education/Training Program | 178 West Maple St, Johnson City, TN 37604 | 2018-04-17 |
| 1821519364 | Mahmoud El Iskandarani | Internal Medicine | 1084 W Oakland Avenue, 748, Johnson City, TN 37604 | 2017-07-06 |
| 1831640937 | Watauga Recovery Center Morristown P.C. | Family Medicine | 1369 W Andrew Johnson Hwy, Johnson City, TN 37604 | 2016-10-24 |
| Find all providers in zip 37604 | ||||
| Taxonomy Code | 2251X0800X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Orthopedic |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174769475 | Mary Anne Sharrow | Physical Therapist | 33-57 Harrison St, Johnson City, NY 13790-2107 | 2008-12-17 |
| 1659407302 | Angela D Higgins | Physical Therapist | 3 Professional Park Dr, Suite 10, Johnson City, TN 37604-6529 | 2007-02-26 |
| 1528128063 | Appalachian Orthopaedic Associates, PC | Physical Therapist | 3 Professional Park Dr, Suite 10, Johnson City, TN 37604-6529 | 2006-12-12 |
| 1477628949 | John W Crowe | Physical Therapist | 3 Professional Park Dr, Suite 10, Johnson City, TN 37604-6529 | 2006-11-21 |
| 1417022989 | Allen R Rhea Jr. | Physical Therapist | 3 Professional Park Dr, Suite 10, Johnson City, TN 37604-6529 | 2006-11-21 |
| 1275581316 | Whitney L Belt | Physical Therapist | 2410 Susannah St, Johnson City, TN 37601-1748 | 2006-05-04 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649896911 | Guillermo Carlos Cutrone | Physical Therapist | 8904a Cross Park Dr, Knoxville, TN 37923-4703 | 2020-06-22 |
| 1619500899 | Barbell Performance Therapy | Physical Therapist | 9607 Eva Marie Way # 216, Knoxville, TN 37931-4278 | 2020-02-17 |
| 1003380908 | Strive To Thrive LLC | Physical Therapist | 101 Brierfield Way, Hendersonville, TN 37075-7220 | 2019-01-14 |
| 1548749625 | Ramyadevi Ramamoorthi | Physical Therapist | 5000 Alpha Lane, Hixson, TN 37343 | 2018-08-09 |
| 1164935375 | Mary Katherine Ford | Physical Therapist | 5822 Lyons View Pike Ste B, Knoxville, TN 37919-6493 | 2017-11-09 |
| 1861902009 | Victoria Campbell | Physical Therapist | 129 Walker Hill St, Crossville, TN 38555-5484 | 2017-10-02 |
| 1750890943 | Simply Physio LLC | Physical Therapist | 111 Loudoun Rd Ste 102, Knoxville, TN 37934-2942 | 2017-09-20 |
| 1730535006 | Jennie Clark | Physical Therapist | 9216 Shawnee Trl, Brentwood, TN 37027-7415 | 2016-05-05 |
| 1114394236 | Matthew Dylan Green | Physical Therapist | 2108 Hemlock Dr, Spring Hill, TN 37174-3147 | 2015-08-24 |
| 1174906036 | Tyler Workman | Physical Therapist | 751b Lynwood Ave, Nashville, TN 37203-5029 | 2015-07-09 |
| Find all providers with the same taxonomy | ||||
| City | JOHNSON CITY |
| Zip Code | 37604 |
Please comment or provide details below to improve the information on MR. BRANT LOGAN NICKENS.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.