Individual provider Active NPI

Bliss Barby L. Mahinay, PT

  • Nursing Facility/Intermediate Care Facility
  • Bartlett, TN
National Provider Identifier
1073737417
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nursing Facility/Intermediate Care FacilityTaxonomy code 313M00000X
License
0000003626 Issued in TN
Practice address
2805 Charles Bryan Rd
Bartlett, TN 38134-4756
Phone
(901) 386-3211
NPI assigned
Apr 13, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nursing Facility/Intermediate Care Facility 313M00000X 0000003626 TN Primary

Addresses

Primary practice location

2805 Charles Bryan Rd
Bartlett, TN 38134-4756

Mailing address

1400 Trail Hill CV
Cordova, TN 38016-6679
Phone (901) 737-0545

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220603000027 TN Practitioner - Physical Therapist in Private Practice 7618355603 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

3168 Hacks Cross Rd
Memphis, TN 38125-8802
Phone (901) 883-0316

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0000003626TNMDNursing Facility/Intermediate Care Facility

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Current Accepting new patients
Aegis Group Practice LLC CurrentSince Oct 2, 2023 Accepting new patients
Ave Maria Home Nursing Facility/Intermediate Care Facility CurrentSince Apr 11, 2022 Accepting new patients
Aegis Group Practice LLC CurrentSince Oct 2, 2023 Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

2805 Charles Bryan Rd
Bartlett, TN 38134
Phone (901) 386-3211

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176422400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073737417",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 TRAIL HILL CV",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380166679",
            "telephone_number": "901-737-0545"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2805 CHARLES BRYAN RD",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "381344756",
            "telephone_number": "901-386-3211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAHINAY",
        "first_name": "BLISS BARBY",
        "middle_name": "L.",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "313M00000X",
            "taxonomy_group": "",
            "desc": "Nursing Facility/Intermediate Care Facility",
            "state": "TN",
            "license": "0000003626",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.