Individual provider Active NPI

Bryan Scott Lange, P.T.

  • Physical Therapist
  • Abilene, TX
National Provider Identifier
1275606295
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1154950 Issued in TX
Practice address
2074 Antilley Rd
Suite 100
Abilene, TX 79606-5209
Phone
(325) 437-1219
Fax
(325) 437-1250
NPI assigned
Nov 16, 2006
Last updated
Oct 23, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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 1154950 TX Primary

Addresses

Primary practice location

2074 Antilley Rd
Suite 100
Abilene, TX 79606-5209

Mailing address

2074 Antilley Rd Ste 100
Abilene, TX 79606-5209
Phone (325) 690-9700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110601000894 TX Practitioner - Physical Therapist in Private Practice 7810174737 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Asmo Overhead, LLPGroup PAC ID 2365629367, 16 clinicians

Practice addresses (Care Compare)

2074 Antilley Rd
Abilene, TX 79606-5209
Phone (325) 698-3865

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Quality
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1154950TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Asmo Overhead, LLP Physical Therapist CurrentSince Mar 11, 2011 Accepting new patients
Asmo Overhead, LLP CurrentSince Mar 11, 2011 Accepting new patients
West Texas Rehabilitation Center Past Accepting new patients

Locations

2074 Antilley Rd
Abilene, TX 79606
Phone (325) 690-9700

2074 Antilley Rd
Ste 100
Abilene, TX 79606
Phone (325) 437-1219

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": "1163635200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1275606295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2074 ANTILLEY RD STE 100",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796065209",
            "telephone_number": "325-690-9700",
            "fax_number": "325-690-9704"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2074 ANTILLEY RD",
            "address_2": "SUITE 100",
            "city": "ABILENE",
            "state": "TX",
            "postal_code": "796065209",
            "telephone_number": "325-437-1219",
            "fax_number": "325-437-1250"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "BRYAN",
        "middle_name": "SCOTT",
        "name_prefix": "Mr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-16",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1154950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Abilene, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.