Individual provider Active NPI

Timothy Branden Bubnick, PT

  • Physical Therapist
  • Lexington, KY
National Provider Identifier
1700292539
Registry record updated Feb 14, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
007378 Issued in KY
Practice address
1588 Leestown Rd Ste 120
Lexington, KY 40511-2365
Phone
(859) 317-8086
Fax
(859) 317-8894
NPI assigned
Jul 1, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 14, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X TN
Physical Therapist 225100000X 007378 KY Primary

Addresses

Primary practice location

1588 Leestown Rd Ste 120
Lexington, KY 40511-2365

Mailing address

6397 Lee Hwy Ste 300
Chattanooga, TN 37421-4915
Phone (423) 238-8930

Other practice location 1

1054 Center Dr Ste 1
Richmond, KY 40475-3851
Phone (859) 625-0600

Other practice location 2

2817 W Andrew Johnson Hwy
Morristown, TN 37814-3216
Phone (423) 586-4810

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181019001544 KY Practitioner - Physical Therapist in Private Practice 5395965750 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10206TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Kentucky LLC Physical Therapist CurrentSince Sep 17, 2018 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Aug 1, 2022 Accepting new patients
Benchmark Physical Therapy of Ky LLC Physical Therapist CurrentSince Mar 11, 2019 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Aug 1, 2022 Accepting new patients
Agilitas USA Inc Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

6408 W Highway 146
Ste 9
Crestwood, KY 40014
Phone (502) 212-2171

1588 Leestown Rd
Ste 120
Lexington, KY 40511
Phone (859) 317-8086

805 Blankenbaker Pkwy
Louisville, KY 40243
Phone (502) 253-0833

805 Blankenbaker Pkwy
Ste 107
Louisville, KY 40243
Phone (502) 253-0833

1054 Center Dr
Ste 1
Richmond, KY 40475
Phone (859) 625-0600

200 Codella Dr
Ste B
Winchester, KY 40391
Phone (859) 745-2152

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

1202 N Charles G Seivers Blvd
Ste A
Clinton, TN 37716
Phone (865) 457-0192

2817 W Andrew Johnson Hwy
Morristown, TN 37814
Phone (423) 586-4810

Organizations & group practices 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1404172800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581638400000",
    "number": "1700292539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214915",
            "telephone_number": "423-238-8930",
            "fax_number": "423-254-5217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1588 LEESTOWN RD STE 120",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405112365",
            "telephone_number": "859-317-8086",
            "fax_number": "859-317-8894"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1054 Center Dr Ste 1",
            "address_purpose": "LOCATION",
            "city": "Richmond",
            "state": "KY",
            "postal_code": "404753851",
            "country_code": "US",
            "telephone_number": "859-625-0600",
            "fax_number": "859-625-0969",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2817 W Andrew Johnson Hwy",
            "address_purpose": "LOCATION",
            "city": "Morristown",
            "state": "TN",
            "postal_code": "378143216",
            "country_code": "US",
            "telephone_number": "423-586-4810",
            "fax_number": "423-586-4811",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BUBNICK",
        "first_name": "TIMOTHY",
        "middle_name": "BRANDEN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-01",
        "last_updated": "2020-02-14",
        "certification_date": "2020-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "007378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2020; 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.