Individual provider Active NPI

Amberly M Bruce, PT, DPT

  • Physical Therapist
  • Knoxville, TN
National Provider Identifier
1437621141
Registry record updated Nov 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11989 Issued in TN
Practice address
970 E Emory Rd
Knoxville, TN 37938-4617
Phone
(865) 947-6622
NPI assigned
Dec 19, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 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 11989 TN Primary

Addresses

Primary practice location

970 E Emory Rd
Knoxville, TN 37938-4617

Mailing address

970 E Emory Rd
Knoxville, TN 37938-4617

Other identifiers 1

IdentifierTypeStateIssuer
Q085567MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190327000415 TN Practitioner - Physical Therapist in Private Practice 1456691864 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11989TNMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Max Potential Bearden, LLC Physical Therapist CurrentSince Aug 14, 2023 Accepting new patients
Max Potential Farragut, LLC Physical Therapist CurrentSince Aug 14, 2023 Accepting new patients

Locations

11201 W Point Dr
Ste 104
Knoxville, TN 37934
Phone (865) 392-6001

8239 Kingston Pike
Knoxville, TN 37919
Phone (865) 500-8500

Organizations & group practices 2

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": "1545177600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731888000000",
    "number": "1437621141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "970 E EMORY RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379384617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "970 E EMORY RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379384617",
            "telephone_number": "865-947-6622"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUCE",
        "first_name": "AMBERLY",
        "middle_name": "M",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-12-19",
        "last_updated": "2024-11-18",
        "certification_date": "2024-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "11989",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q085567",
            "state": "TN"
        }
    ],
    "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 Nov 18, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.