Bradford Jamal Kennebrew, PTA
NPI 1811623242ActiveIndividual· Physical Therapy Assistant· Stone Mountain, GA
Physical Therapy Assistant (PTA) in Stone Mountain, Georgia, licensed in GA, with an NPI issued in July 2022.
Overview
| NPI | 1811623242 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | PTA |
| Sole proprietor | No |
| NPI issued | Jul 27, 2022 |
| Last updated in NPPES | Aug 29, 2022 |
| Certified by provider | Aug 29, 2022 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapy Assistant Primary | 225200000X | PTA003995 | GA |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Physical Therapy Assistant providers in Stone Mountain
- 1942788310
- 1588124879
- 1861734204
- 1083355796
- 1043242837
- 1265759583
- 1811432040
- 1114481736
- 1932665353
- 1164832853
- 1134346471
- 1952646259