Active NPI
Keri Bryan
- Physical Therapy Assistant
- Tyler, TX
National Provider Identifier
1417362252
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 4053120
- Practice address
- 921 Shiloh Rd Ste C110
Tyler, TX 75703-1406 - Phone
- (903) 939-2800
- NPI assigned
- Jun 30, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 4053120 | TX | Primary |
Addresses
Primary practice location
921 Shiloh Rd Ste C110
Tyler, TX 75703-1406
Mailing address
921 Shiloh Rd Ste C110
Tyler, TX 75703-1406
Phone (903) 939-2800
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4053120 | TX | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Cole Health, Inc. | Past | Accepting new patients |
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, 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": "1404086400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1633996800000",
"number": "1417362252",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "921 SHILOH RD STE C110",
"city": "TYLER",
"state": "TX",
"postal_code": "757031406",
"telephone_number": "903-939-2800"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "921 SHILOH RD STE C110",
"city": "TYLER",
"state": "TX",
"postal_code": "757031406",
"telephone_number": "903-939-2800"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRYAN",
"first_name": "KERI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-06-30",
"last_updated": "2021-10-12",
"certification_date": "2021-10-12",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TX",
"license": "4053120",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyler, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.