Organization Active NPI

Drayer Physical Therapy Indiana LLC

  • Physical Therapist
  • Fort Wayne, IN
National Provider Identifier
1124624903
Registry record updated Dec 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
DRAYER PHYSICAL THERAPY INDIANA LLC
Practice address
9522 Lima Rd Ste 103
Fort Wayne, IN 46818-9808
Phone
(260) 483-2422
NPI assigned
Dec 8, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2020

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

Authorized official

Name
Bryan Bargainer
Title
Cfo
Phone
(423) 238-7217

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

9522 Lima Rd Ste 103
Fort Wayne, IN 46818-9808

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

National Provider Directory

National Provider Directory
Tax ID family
Drayer Physical Therapy Indiana LLC3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1607385600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1607385600000",
    "number": "1124624903",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9522 LIMA RD STE 103",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468189808",
            "telephone_number": "260-483-2422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DRAYER PHYSICAL THERAPY INDIANA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-08",
        "last_updated": "2020-12-08",
        "certification_date": "2020-12-08",
        "status": "A",
        "authorized_official_last_name": "BARGAINER",
        "authorized_official_first_name": "BRYAN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "423-238-7217"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Wayne, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.