Mark Avery, PT, DPT
Individual provider Active NPI Physical Therapist · Canton, NY
NPI 1679480701 · NPPES record last updated Aug 25, 2026
Key facts
- NPI
- 1679480701
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 056237 (NY)
- Practice address
- 6119 US Highway 11
Canton, NY 13617-3991 - Phone
- (315) 261-5497
- NPI assigned
- Aug 25, 2026
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 056237 | NY | Yes |
Addresses
Primary practice location
6119 US Highway 11
Canton, NY 13617-3991
Mailing address
6119 US Highway 11
Canton, NY 13617-3991
Other practice location 1
80 E Main St
Canton, NY 13617-1450
Phone (315) 265-3300
Other providers in Canton, NY
- Kendell Arndt
- Heather Aschenbrenner
- Shannon Ashley
- Brian Atkins
- Zachary Michael Austin
- Emily Ruth Badlam
- Brandon Bahr
- Ulana M. Ballan
- Justin Roger Barkley
- Miranda J Barksdale
All providers in Canton, NY · Physical Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.