Individual provider Active NPI

Taryn A Bader, D.P.T

  • Physical Therapist
  • Skaneateles, NY
National Provider Identifier
1124312533
Registry record updated Feb 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
791 W Genesee Street Rd
Skaneateles, NY 13152-9377
Phone
(315) 685-7544
Fax
(315) 685-7549
NPI assigned
Jun 2, 2011
Last updated
Feb 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

791 W Genesee Street Rd
Skaneateles, NY 13152-9377

Mailing address

4651 Nixon Park Dr
Syracuse, NY 13215-9759
Phone (315) 635-5000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220517000704 TN Practitioner - Physical Therapist in Private Practice 4587835905 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
East Tennessee Spine & Sport Inc Physical Therapist CurrentSince Oct 1, 2022 Accepting new patients
Independent Physical Therapy, LLC Physical Therapist CurrentSince May 16, 2022 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

1202 N Charles G Seivers Blvd
Ste A
Clinton, TN 37716
Phone (865) 457-0192

1319 Old Weisgarber Rd
Knoxville, TN 37909
Phone (865) 217-6853

142 W End Ave
Knoxville, TN 37934
Phone (865) 249-7566

4905 N Broadway St
Knoxville, TN 37918
Phone (865) 689-8299

7240 Kingston Pike
Ste 160
Knoxville, TN 37919
Phone (602) 762-0756

8905 Town and Country Cir
Ste 9
Knoxville, TN 37923
Phone (865) 529-9185

501 Adesa Blvd
Ste A140
Lenoir City, TN 37771
Phone (865) 333-1461

142 Fairbanks Rd
Ste 150
Oak Ridge, TN 37830
Phone (865) 888-5431

Organizations & group practices 2

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": "1306972800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455235200000",
    "number": "1124312533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 NIXON PARK DR",
            "city": "SYRACUSE",
            "state": "NY",
            "postal_code": "132159759",
            "telephone_number": "315-635-5000",
            "fax_number": "315-492-1203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "791 W GENESEE STREET RD",
            "city": "SKANEATELES",
            "state": "NY",
            "postal_code": "131529377",
            "telephone_number": "315-685-7544",
            "fax_number": "315-685-7549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BADER",
        "first_name": "TARYN",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "D.P.T",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-02",
        "last_updated": "2016-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Skaneateles, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.