Lynn Gillies Bruder, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P19088 Issued in NC

Practice address

90 Crossroad Hill Rd
Canton, NC 28716-3703

Phone

(828) 492-0592

Fax

(828) 492-0593

NPI assigned

Aug 14, 2019

Last updated

Oct 29, 2021By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lynn.bruder.p12@direct.athleticoltd.nextgenshare.com

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.

• Activcare Physical Therapy, LLC

  dba Pivot Physical Therapy of Carolina

  • Clinic/Center
  • Raleigh, NC
  • NPI 1548409626

  Physical Therapist

  Medicare reassignment NPD
• Weaverville Physical Therapy and Wellness

  dba Big Ivy Physical Therapy and Wellness

  • Physical Therapy Clinic/Center
  • Weaverville, NC
  • NPI 1700446770

  Physical Therapist

  Medicare reassignment NPD
• Breakthrough Physical Therapy

  • Physical Therapist
  • Morehead City, NC
  • NPI 1083937692
  NPD (past)
• Breakthrough Physical Therapy Inc

  • Physical Therapist
  • Fayetteville, NC
  • NPI 1285958348
  NPD (past)

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

{
    "created_epoch": "1565740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1649826744",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 NEW FIDELITY CT",
            "city": "GARNER",
            "state": "NC",
            "postal_code": "275292665",
            "telephone_number": "919-578-4538",
            "fax_number": "919-388-8668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "90 CROSSROAD HILL RD",
            "city": "CANTON",
            "state": "NC",
            "postal_code": "287163703",
            "telephone_number": "828-492-0592",
            "fax_number": "828-492-0593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUDER",
        "first_name": "LYNN",
        "middle_name": "GILLIES",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-14",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P19088",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nikolas Chase Bixenman, DC
• Megan Blaylock
• Shelia Marie Branch, COTA/L
• Mary Bridges, PT
• Jamie M Brinson, FNP-C, ENP-C
• Ryan Scott Buchanan, LCMHC
• Bryce Palmer Burgess
• Holly Burnette, COTA/L
• Jacqueline Burris, PTA, MPH
• Samuel Burrus

• Physical Therapist in Canton, NC
• Providers in Canton, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 29, 2021; 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.