Jacoby Brewer, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11817 Issued in TN

Practice address

321 Dexter L Woods Memorial Blvd Ste 3
Waynesboro, TN 38485-2418

Phone

(931) 332-3541

NPI assigned

Jun 6, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Prime Physical TherapyGroup PAC ID 3476931965, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Prime Physical Therapy

  • Physical Therapist
  • Waynesboro, TN
  • NPI 1699417048
  Medicare reassignment Care Compare group NPD Authorized official
• Prestige Physical Therapy

  • Physical Therapy Clinic/Center
  • Columbia, TN
  • NPI 1053566463
  NPD (past)
• Sonnys Place of Waynesboro

  • Occupational Therapist
  • Waynesboro, TN
  • NPI 1073299681
  NPD (past)

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

{
    "created_epoch": "1528243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649030400000",
    "number": "1386136125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2554 GROVE PARK WAY",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384011586",
            "telephone_number": "931-332-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 DEXTER L WOODS MEMORIAL BLVD STE 3",
            "city": "WAYNESBORO",
            "state": "TN",
            "postal_code": "384852418",
            "telephone_number": "931-332-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREWER",
        "first_name": "JACOBY",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-06",
        "last_updated": "2022-04-04",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "11817",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Best Medical Inc.
• James Robert Biggers Jr., D.O.
• Rajpati Bodh-Ceres, NP
• Rachel Larae Boone, PHARM.D.
• Erin Lyn Brewer, B.A.
• Brian David Brison, PTA
• Buffalo River Services, Inc.
• Ryan Owen Bundren, LADAC II
• Chelsea Leigh Butcher
• Macon Devaughn Carroll, PHARM.D.

• Physical Therapist in Waynesboro, TN
• Providers in Waynesboro, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 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.