LANDEN BROCK (PT, DPT) – Physical Therapist, NPI 1356027973

LANDEN BROCK (PT, DPT) is a healthcare provider. based in Tucker, Georgia. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT, DPT. They hold a License No. PTO16664 (GA). The NPI Number for LANDEN BROCK (PT, DPT) is 1356027973

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
LANDEN BROCK (PT, DPT)
NPI
1356027973
Phone
(205) 480-4466
Address
2138 DILLARD XING
Enumeration Date
27 June 2023
Last Update Date
27 June 2023

Doctor Profile

Medical School Name
EMORY UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
2059697887
Graduation Year
2023 (3 years ago)
PAC ID
8820528672
Group Practice PAC ID
7012085137
Professional Enrollment ID
I20250207002556
Address ID
AL352432333VE3125XDRXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

2,870 PHYSICAL THERAPIST IN PRIVATE PRACTICE in GA

Provider Addresses for LANDEN BROCK (PT, DPT)

  • 2138 DILLARD XING

    TUCKER, GA 300845878

    Phone: (205) 480-4466

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-02-07

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250207002556IPhysical Therapist In Private PracticeALTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 30084)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7012085137View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeAL
Physical Therapist In Private PracticeAL
Physical Therapist In Private PracticeAL
-AL
Physical Therapist In Private PracticeNC
Physical Therapist In Private PracticeAL
-TN
Physical Therapist In Private PracticeAL

Reviews

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Frequently asked questions

What unique ID ties claims to LANDEN BROCK (PT, DPT)?
NPI 1356027973 is assigned to LANDEN BROCK (PT, DPT) under the national enumeration system.
Is LANDEN BROCK (PT, DPT)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What does LANDEN BROCK (PT, DPT) treat or focus on?
Patients typically see LANDEN BROCK (PT, DPT) under the specialty Physical Therapist. Clinical services aligned with this taxonomy classification.
Where does public data place LANDEN BROCK (PT, DPT)?
The snapshot lists Tucker, Georgia for LANDEN BROCK (PT, DPT); download NPPES for the complete set.
Is LANDEN BROCK (PT, DPT) a real provider?
This page reflects official NPPES data for NPI 1356027973. Always confirm identity and privileges with the practice and licensing boards.

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