Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Brendon Blake, PT

Individual provider Physical Therapist · NPI 1508804428

Mr. Brendon Blake, PT is a Physical Therapist in Private Practice in Flowery Branch, Georgia. Qualified in 1999, 27 years ago. Practices with Back in the Game Physical Therapy, Inc, a 17-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
27
Licensed in
GA
In the registry since
2006
What do these letters mean?
PT — Physical Therapist
A licensed therapist who treats movement, pain and injury.

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Practice location Address checks out

4754 Martin Rd Ste 200
Flowery Branch, GA 30542-3507
Phone: (770) 967-4377
Fax: (770) 967-8077
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence 7433 (GA)

Record details

NPI number1508804428
Entity typeIndividual (Type 1)
GenderMale
Credentials PT
Sole proprietorYes
NPI enumeratedJune 3, 2006
Last updated in NPPESDecember 12, 2011
Mailing address4754 Martin Rd, Suite 200, Flowery Branch, GA 30542-3507

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1999 (27 years in practice)
Group practice Back In The Game Physical Therapy, Inc — 17 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Flowery Branch