Physician Compare National (NPI:1285980862)

HEALTHCARE PROVIDER: BRANDON JEREMY REGISTER PH.D.

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1285980862
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	9830327824
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20140121001442
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	REGISTER
	Individual professional last name
Provider First Name	BRANDON
	Individual professional first name
Provider Middle Name	JEREMY
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2010
	Individual professional's medical school graduation year
Primary Specialty	PSYCHOLOGIST, CLINICAL
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	2881 MONROE HWY 503
	Group Practice or individual's line 1 address
City	WATKINSVILLE
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	306778529
	Group Practice or individual's zip code (9 digits when available)
Phone Number	7063383919
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y