Individual provider Active NPI

Karen Rebecca McBrayer, P.T., D.P.T.

  • Physical Therapist
  • Maryville, TN
National Provider Identifier
1215243779
Registry record updated Apr 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8278 Issued in TN
Practice address
2030 Chilhowee Medical Park
Maryville, TN 37804-5285
Phone
(865) 982-3400
Fax
(865) 238-2034
NPI assigned
Aug 23, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 2, 2018

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 8278 TN Primary

Addresses

Primary practice location

2030 Chilhowee Medical Park
Maryville, TN 37804-5285

Mailing address

PO Box 5209
Maryville, TN 37802-5209
Phone (865) 982-3400

Other identifiers 1

IdentifierTypeStateIssuer
Q025606MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221108001865 TN Practitioner - Physical Therapist in Private Practice 5294102083 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grace Rehabilitation Center, Inc. Physical Therapist CurrentSince Sep 15, 2022 Accepting new patients
Speech Pathology Services of East Tennessee LLC Physical Therapist Past Accepting new patients
Little Tennessee Valley Educational Cooperative Past Accepting new patients

Locations

2435 Jacksboro Pike
Ste 2
La Follette, TN 37766
Phone (423) 566-2250

2435 Jacksboro Pike
La Follette, TN 37766
Phone (423) 566-2250

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, 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": "1282521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1522627200000",
    "number": "1215243779",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5209",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378025209",
            "telephone_number": "865-982-3400",
            "fax_number": "865-238-2034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 CHILHOWEE MEDICAL PARK",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378045285",
            "telephone_number": "865-982-3400",
            "fax_number": "865-238-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCBRAYER",
        "first_name": "KAREN",
        "middle_name": "REBECCA",
        "name_prefix": "Dr.",
        "credential": "P.T., D.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-08-23",
        "last_updated": "2018-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "8278",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q025606",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Maryville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2018; 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.