Individual provider Active NPI

Yonel Bredy Jr., DPT

  • Physical Therapist
  • Matthews, NC
National Provider Identifier
1619042298
Registry record updated Apr 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P20059 Issued in NC
Practice address
10590 Independence Pointe Pkwy
Ste 201
Matthews, NC 28105-4176
Phone
(786) 269-8070
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2023

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 P20059 NC Primary

Addresses

Primary practice location

10590 Independence Pointe Pkwy
Ste 201
Matthews, NC 28105-4176

Mailing address

10590 Independence Pointe Pkwy
Ste 201
Matthews, NC 28105-4176
Phone (786) 269-8070

Other identifiers 1

IdentifierTypeStateIssuer
1619042298MedicaidNC

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
P20059NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physical Therapy in Your Home Inc Past Accepting new patients
Trinity 5 Inc Physical Therapist PastSince Jul 5, 2020 Accepting new patients

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681344000000",
    "number": "1619042298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10590 INDEPENDENCE POINTE PKWY",
            "address_2": "STE 201",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281054176",
            "telephone_number": "786-269-8070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10590 INDEPENDENCE POINTE PKWY",
            "address_2": "STE 201",
            "city": "MATTHEWS",
            "state": "NC",
            "postal_code": "281054176",
            "telephone_number": "786-269-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BREDY",
        "first_name": "YONEL",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2023-04-13",
        "certification_date": "2023-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P20059",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1619042298",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Matthews, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.