DR. BRANDON CHARLES DENNIS (NPI# 1457679276) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1457679276 |
| Entity Type | Individual |
| Full Name | DR. BRANDON CHARLES DENNIS |
| Credential | PSY.D. |
| Practice Address |
4950 Norton Healthcare Blvd Ste 305 Louisville KY 40241 |
| Mailing Address |
4950 Norton Healthcare Blvd Ste 305 Louisville KY 40241-2849 |
| Practice Telephone | 5023946460 |
| Practice Fax Number | 5023946465 |
| Mailing Telephone | 5023946460 |
| Mailing Fax Number | 5023946465 |
| Enumeration Date | 2010-05-05 |
| Last Update Date | 2020-10-13 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 1654 | KY | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
1654 | KY | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | MEDICARE | K214080-KOHMG | 01 |
| KY | 7100435060 (KOHMG) | 05 | |
| IN | 201398770A (KOHMG) | 05 | |
| KY | RR MEDICARE | P017311-KOHMG | 01 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4950 Norton Healthcare Blvd Ste 305, Louisville, KY 40241 | 5023946460 | 5023946465 |
| Street Address |
4950 NORTON HEALTHCARE BLVD STE 305 |
| City | LOUISVILLE |
| State | KY |
| Zip Code | 40241 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396759072 | Tammy S Evanow | Nurse Practitioner | 4950 Norton Healthcare Blvd Ste 305, Louisville, KY 40241 | 2006-07-28 |
| 1891291324 | Lauren Johnson | Nurse Practitioner | 4950 Norton Healthcare Blvd Ste 305, Louisville, KY 40241 | 2018-04-03 |
| 1073056917 | Courtney J Ware | Nurse Practitioner | 4950 Norton Healthcare Blvd Ste 305, Louisville, KY 40241-2849 | 2016-11-26 |
| 1235444589 | Kelly Buszkiewicz | Counselor | 4950 Norton Healthcare Blvd Ste 305, Louisville, KY 40241-2849 | 2010-08-11 |
| 1881911527 | Danny Ray Rose Jr. | Psychiatry & Neurology | 4950 Norton Healthcare Blvd Ste 305, Louisville, KY 40241-2849 | 2010-04-20 |
| 1285827725 | Mahan Ghiassi | Neurological Surgery | 4950 Norton Healthcare Blvd Ste 305, Louisville, KY 40241-2849 | 2007-08-18 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164033353 | Tyler Roberts | Physician Assistant | Private, Louisville, KY 40241 | 2020-08-12 |
| 1639636988 | Paladina Health, LLC | Family Medicine | Paladina Health Louisville Park Plaza, 9720 Park Plaza Avenue #101, Louisville, KY 40241 | 2019-02-22 |
| 1164990396 | Tiffany Elizabeth Gallucci | Nurse Practitioner | 4915 Norton Healthcare Boulevard, Louisville, KS 40241 | 2018-11-06 |
| 1952876146 | Ashley Lynne Johnson Belcher | Psychologist | 9700 Park Plaza Avenue, Ste. 106, Louisville, KY 40241 | 2018-10-04 |
| 1265935977 | Family Podiatry Center Pllc | Podiatrist | 9850 Von Allmen Ct, Louisville, KY 40241 | 2018-03-09 |
| 1346767472 | Bridgett Lin Youngblood | Case Manager/Care Coordinator | 4313 Brownsboro Glen Rd, Louisville, KY 40241 | 2017-08-29 |
| 1518375690 | Amir Shahla | Dentist | 10500 Fischer Park Dr, Louisville, KY 40241 | 2014-08-01 |
| 1255741781 | Alicia M Durham | Marriage & Family Therapist | 3900 Riveroaks Ln, Louisville, KY 40241 | 2014-05-06 |
| 1962826719 | Applied Behavioral Consulting, LLC | Community/Behavioral Health | 4517 Shenandoah Drive, Louisville, KY 40241 | 2014-02-14 |
| 1336579176 | Nicholas Weickel | Physical Therapist | 9880 Angie's Way, Suite 100, Louisville, KY 40241 | 2013-11-14 |
| Find all providers in zip 40241 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437393170 | Bradley Scott Folley | Clinical Neuropsychologist | 4950 Norton Healthcare Blvd Ste 205, Louisville, KY 40241-2847 | 2009-04-24 |
| 1265689475 | Marilyn M. Wagner Ph.d., Psc | Clinical Neuropsychologist | 105a Crescent Ave, Louisville, KY 40206-1525 | 2008-08-20 |
| 1073704011 | Jennifer A Geiger | Clinical Neuropsychologist | 275 Century Cir Ste 203, Louisville, CO 80027-9453 | 2007-08-06 |
| 1619186467 | James Frederick Phifer | Clinical Neuropsychologist | 440 Breckenridge Lane Ste 124, Louisville, KY 40218 | 2007-05-21 |
| 1508916958 | Michael H Cecil | Clinical Neuropsychologist | 13293 Obannon Station Way, Louisville, KY 40223-4188 | 2007-01-10 |
| 1396763249 | Jacquelyn J. Graven | Clinical Neuropsychologist | 421 Benjamin Lane, Ste 202, Louisville, KY 40222 | 2006-07-18 |
| 1154301356 | Donald Bradley Burton | Clinical Neuropsychologist | 4200 Browns Ln, Louisville, KY 40220-1523 | 2006-01-23 |
| 1356333090 | Melissa A Boyles | Clinical Neuropsychologist | 2915 Frankfort Ave, Suite E, Louisville, KY 40206-2682 | 2005-08-18 |
| 1518968205 | Richard I Edelson | Clinical Neuropsychologist | 7511 New Lagrange Rd, Louisville, KY 40222-4859 | 2005-08-03 |
| 1164429320 | Jeanne Marie Bennett | Clinical Neuropsychologist | 1169 Eastern Pkwy Ste 2238, Louisville, KY 40217-1444 | 2005-07-02 |
| Find all providers in LOUISVILLE | ||||
| City | LOUISVILLE |
| Zip Code | 40241 |
Please comment or provide details below to improve the information on DR. BRANDON CHARLES DENNIS.
| 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.