Bryant W. Lary, R.P.T.
Individual provider Active NPI Physical Therapist · Belzoni, MS
NPI 1366439341 · NPPES record last updated Mar 13, 2008
Key facts
- NPI
- 1366439341
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT1324 (MS)
- Practice address
- 401 N Hayden St
Belzoni, MS 39038-3639 - Phone
- (662) 247-4446
- Fax
- (662) 247-2772
- NPI assigned
- Oct 4, 2005
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1993
- Medicare assignment
- May accept Medicare assignment
- Group practices
- Professional Physical Therapy, Inc.
Practice addresses (Care Compare)
401 N Hayden St
Belzoni, MS 39038-3639
Phone (662) 247-4446
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in MS
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120530000142 | MS | Practitioner - Physical Therapist in Private Practice | 0042200974 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Advanced Rehabilitation, LLC | Physical Therapist | Current |
Accepting new patients |
Locations
702 Highway 82 W
Ste B
Greenwood, MS 38930
Phone (662) 455-5010
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT1324 | MS | Yes |
Addresses
Primary practice location
401 N Hayden St
Belzoni, MS 39038-3639
Mailing address
401 N Hayden St
Belzoni, MS 39038-3639
Phone (662) 247-4446
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 04250591 | Medicaid | MS |
Other providers in Belzoni, MS
- Humphreys County Memorial Hospital
- Indianola Sleep Clinic, LLC
- Lee L James
- Lori D Johnson
- Sanchasity Nicole Kimber
- Cherelle J Latiker
- Level Up
- Ulonda Liddell
- Jessica Leigh Lloyd
- Long'S Drug Store
All providers in Belzoni, MS · Physical Therapist in Mississippi
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 13, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.