Prime Physical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PRIME PHYSICAL THERAPY

Practice address

321 Dexter L Woods Memorial Blvd Ste B
Waynesboro, TN 38485-2418

Phone

(931) 332-3541

NPI assigned

Apr 7, 2022

Last updated

Feb 2, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jacoby Brewer, DPTNPI 1386136125

Title

Owner

Phone

(931) 332-3541

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacoby Brewer, PT, DPT

  • Physical Therapist
  • Waynesboro, TN
  • NPI 1386136125
  Medicare reassignment Care Compare group NPD Authorized official
• Alden Littlejohn, PT

  • Physical Therapist
  • Waynesboro, TN
  • NPI 1902518178
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1649289600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706832000000",
    "number": "1699417048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2554 GROVE PARK WAY",
            "city": "COLUMBIA",
            "state": "TN",
            "postal_code": "384011586",
            "telephone_number": "931-332-3541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "321 DEXTER L WOODS MEMORIAL BLVD STE B",
            "city": "WAYNESBORO",
            "state": "TN",
            "postal_code": "384852418",
            "telephone_number": "931-332-3541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-04-07",
        "last_updated": "2024-02-02",
        "certification_date": "2024-02-02",
        "status": "A",
        "authorized_official_last_name": "BREWER",
        "authorized_official_first_name": "JACOBY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "931-332-3541",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "JBrewerDPT@TNPrimePT.com",
            "affiliation": "N",
            "endpointDescription": "Email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "321 Dexter L Woods Memorial Blvd Ste C",
            "city": "Waynesboro",
            "state": "TN",
            "country_code": "US",
            "postal_code": "384852418",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Donald H Polk, DO
• Alexandria Nicole Popeholt, MSN, FNP
• Kendra R Prater-Holt, NP
• Donna J Prater, APN
• Nelda Prater, M.A.
• Sherry Lynn Prince
• Cassie Pyle, PHARMD
• Brent Rainwater, PHARMD
• Freda A Ray, MSW
• Restoration Psychiatric Care, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2024; 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.