Individual provider Active NPI

Forrest Richard Dyer, DPT

  • Physical Therapist
  • Knoxville, TN
National Provider Identifier
1306338447
Registry record updated Aug 15, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11711 Issued in TN
Practice address
221 W Young High Pike
Knoxville, TN 37920-3051
Phone
(865) 573-6458
Fax
(865) 577-8147
NPI assigned
Jun 5, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2022

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 11711 TN Primary

Addresses

Primary practice location

221 W Young High Pike
Knoxville, TN 37920-3051

Mailing address

221 W Young High Pike
Knoxville, TN 37920-3051
Phone (865) 573-6458

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181124000098 TN Practitioner - Physical Therapist in Private Practice 3971857376 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Foothills Physical Therapy LLCGroup PAC ID 5395127724, 5 clinicians

Practice addresses (Care Compare)

221 W Young High Pike
Knoxville, TN 37920-3051
Phone (865) 573-6458

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11711TNMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Foothills Physical Therapy LLC Physical Therapist CurrentSince Aug 1, 2022 Accepting new patients

Locations

221 W Young High Pike
Knoxville, TN 37920
Phone (865) 573-6458

Organizations & group practices 1

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": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1660521600000",
    "number": "1306338447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 W YOUNG HIGH PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379203051",
            "telephone_number": "865-573-6458",
            "fax_number": "865-577-8147"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 W YOUNG HIGH PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379203051",
            "telephone_number": "865-573-6458",
            "fax_number": "865-577-8147"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DYER",
        "first_name": "FORREST",
        "middle_name": "RICHARD",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-05",
        "last_updated": "2022-08-15",
        "certification_date": "2022-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "11711",
            "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 15, 2022; 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.