Individual provider Active NPI

Shaun D Bry, DPT

  • Physical Therapist
  • Escondido, CA
National Provider Identifier
1194339374
Registry record updated Sep 3, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
297514 Issued in CA
Practice address
2413 N Summit Circle GLN
Escondido, CA 92026-3813
Phone
(916) 798-1929
NPI assigned
Sep 3, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2020

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 297514 CA Primary

Addresses

Primary practice location

2413 N Summit Circle GLN
Escondido, CA 92026-3813

Mailing address

2413 N Summit Circle GLN
Escondido, CA 92026-3813
Phone (916) 798-1929

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200930002403 CA Practitioner - Physical Therapist in Private Practice 2466871009 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
297514CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Orthopaedic and Neurological Rehab Inc Physical Therapist CurrentSince Apr 1, 2021 Accepting new patients
Orthopaedic and Neurological Rehabilitation, Speech Pathology, Inc CurrentSince Apr 1, 2021 Accepting new patients
California Luna Care Physical Therapy PC Physical Therapist CurrentSince Oct 1, 2020 Accepting new patients

Locations

2950 Sierra Sunrise Ter
Chico, CA 95928
Phone (530) 941-1017

9000 Murray Dr
La Mesa, CA 91942
Phone (585) 451-4018

16185 Los Gatos Blvd
Ste 205
Los Gatos, CA 95032
Phone (408) 459-8108

3900 Dale Rd
Modesto, CA 95356
Phone (209) 492-0128

177 Mary Ave
Nipomo, CA 93444
Phone (805) 600-3366

3499 Grande Vista Dr
Thousand Oaks, CA 91320
Phone (949) 485-2022

3210 Sepulveda Blvd
Torrance, CA 90505
Phone (424) 571-2603

8500 Bluffstone Cv
Ste A201
Austin, TX 78759
Phone (512) 220-5252

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1599091200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599091200000",
    "number": "1194339374",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2413 N SUMMIT CIRCLE GLN",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920263813",
            "telephone_number": "916-798-1929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2413 N SUMMIT CIRCLE GLN",
            "city": "ESCONDIDO",
            "state": "CA",
            "postal_code": "920263813",
            "telephone_number": "916-798-1929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRY",
        "first_name": "SHAUN",
        "middle_name": "D",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-09-03",
        "last_updated": "2020-09-03",
        "certification_date": "2020-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "297514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Escondido, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2020; 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.