Jerry Edward Presley, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT0000005425 Issued in TN

Practice address

2265 Parr Ave
Dyersburg, TN 38024-2078

Phone

(731) 285-6600

Fax

(731) 285-8005

NPI assigned

Jun 12, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Physical Therapy of Dyersburg PC

  • Physical Therapist
  • Dyersburg, TN
  • NPI 1649218140
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1150070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295481600000",
    "number": "1669414629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2265 PARR AVE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242078",
            "telephone_number": "731-285-6600",
            "fax_number": "731-285-8005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2265 PARR AVE",
            "city": "DYERSBURG",
            "state": "TN",
            "postal_code": "380242078",
            "telephone_number": "731-285-6600",
            "fax_number": "731-285-8005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PRESLEY",
        "first_name": "JERRY",
        "middle_name": "EDWARD",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-12",
        "last_updated": "2011-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT0000005425",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY LICENSE",
            "identifier": "PT0000005425",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3687549",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brien R. Polk, DDS
• Powell Transportation Services
• Judy A Powell, CRNA
• Michael Prater, SLP
• Premise Health of Tennessee Medical PC
• Prewitt Medical Care Clinic PC
• Darrion Jewayne Prewitt, MD
• Jason C Price, PHARMD
• Karen Dawn Priest, PTA
• Randall Paris Prince, DDS

• Physical Therapist in Dyersburg, TN
• Providers in Dyersburg, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2011; 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.