Individual provider Active NPI

Jason R. Bruer, PT

  • Physical Therapist
  • Knoxville, TN
National Provider Identifier
1215988811
Registry record updated Aug 30, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5903 Issued in TN
Practice address
1320 Old Weisgarber Rd
Knoxville, TN 37909-1291
Phone
(865) 584-1054
Fax
(865) 588-8350
NPI assigned
May 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 30, 2010

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 5903 TN Primary

Addresses

Primary practice location

1320 Old Weisgarber Rd
Knoxville, TN 37909-1291

Mailing address

PO Box 52268
Knoxville, TN 37950-2268
Phone (865) 584-1054

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5903TNMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Familycare Specialists PC Past Accepting new patients
Covenant Medical Group, Inc Past Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1283126400000",
    "number": "1215988811",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 52268",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379502268",
            "telephone_number": "865-584-1054",
            "fax_number": "865-588-8350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1320 OLD WEISGARBER RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379091291",
            "telephone_number": "865-584-1054",
            "fax_number": "865-588-8350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUER",
        "first_name": "JASON",
        "middle_name": "R.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-16",
        "last_updated": "2010-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "5903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2010; 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.