Encore Physical Therapy, PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

ENCORE PHYSICAL THERAPY, PLLC

Practice address

100 Kasson Rd
Camillus, NY 13031-2250

Phone

(607) 745-7441

NPI assigned

Jun 23, 2020

Organization subpart

No

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

Authorized official

Name

Dr. Taryn A Bader, PT, DPT

Title

Owner/Co-Founder

Phone

(607) 745-7441

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1592870400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1592870400000",
    "number": "1639795982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3851 SLATE HILL RD",
            "city": "MARCELLUS",
            "state": "NY",
            "postal_code": "131089639",
            "telephone_number": "607-745-7441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 KASSON RD",
            "city": "CAMILLUS",
            "state": "NY",
            "postal_code": "130312250",
            "telephone_number": "607-745-7441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENCORE PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-06-23",
        "last_updated": "2020-06-23",
        "certification_date": "2020-06-23",
        "status": "A",
        "authorized_official_last_name": "BADER",
        "authorized_official_first_name": "TARYN",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER/CO-FOUNDER",
        "authorized_official_telephone_number": "607-745-7441",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03448675",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Eckerd Corporation
• Scott A Edison, MD
• Okosun Edoro, MD
• Justin Robert Edwards, OPTICIAN
• Emerging Vision Inc
• Ashley Engelbrecht, RN
• Marc Darren Engle, D.D.S.
• Epc, LLC
• Fairmount Family Medicine PLLC
• Anne Marie G Fallon, D.D.S.

• Physical Therapist in Camillus, NY
• Providers in Camillus, NY by specialty
• Physical Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2020; 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.