Individual provider Active NPI

Larry P Bryant, PT

  • Physical Therapist
  • Ellijay, GA
National Provider Identifier
1629072020
Registry record updated Jun 1, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6005 Issued in GA
Practice address
943 Progress Rd
Ellijay, GA 30540-8800
Phone
(706) 698-3000
Fax
(706) 698-3001
NPI assigned
Jun 13, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 1, 2012

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 6005 GA Primary

Addresses

Primary practice location

943 Progress Rd
Ellijay, GA 30540-8800

Mailing address

943 Progress Rd
Ellijay, GA 30540-8800
Phone (706) 698-3000

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090216000463 GA Practitioner - Physical Therapist in Private Practice 2668537200 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bryant Physical TherapyGroup PAC ID 7113082751, 6 clinicians

Practice addresses (Care Compare)

943 Progress Rd
Ellijay, GA 30540-8800
Phone (706) 698-3000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6005GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bryant Physical Therapy Physical Therapist CurrentSince Mar 1, 2009 Accepting new patients

Locations

943 Progress Rd
Ellijay, GA 30540
Phone (706) 633-3421

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1118620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338508800000",
    "number": "1629072020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "943 PROGRESS RD",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305408800",
            "telephone_number": "706-698-3000",
            "fax_number": "706-698-3001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "943 PROGRESS RD",
            "city": "ELLIJAY",
            "state": "GA",
            "postal_code": "305408800",
            "telephone_number": "706-698-3000",
            "fax_number": "706-698-3001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRYANT",
        "first_name": "LARRY",
        "middle_name": "P",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-13",
        "last_updated": "2012-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "6005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellijay, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2012; 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.