Individual provider Active NPI

Tara Marie Bries, MPT

  • Physical Therapist
  • Davenport, IA
National Provider Identifier
1750654604
Registry record updated Feb 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
03375 Issued in IA
Practice address
3385 Dexter CT
Suite 203
Davenport, IA 52807-3494
Phone
(563) 332-9312
Fax
(563) 332-9316
NPI assigned
Feb 22, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 22, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 03375 IA Primary

Addresses

Primary practice location

3385 Dexter CT
Suite 203
Davenport, IA 52807-3494

Mailing address

850 43Rd Ave
Suite 100
Moline, IL 61265-8401
Phone (309) 743-2070

Other names 1

  • Tara Marie Burmeister Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120516000391 IA Practitioner - Physical Therapist in Private Practice 3779746474 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Iowa, RJ & L Carver College of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Rock Valley Physical Therapy CenterGroup PAC ID 9638087877, 232 clinicians

Practice addresses (Care Compare)

3385 Dexter CT
Suite 203
Davenport, IA 52807-3471
Phone (563) 332-9312

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
03375IAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Rock Valley Physical Therapy Center Physical Therapist CurrentSince Mar 20, 2012 Accepting new patients
Rock Valley Physical Therapy Center Physical Therapist CurrentSince Mar 20, 2012 Accepting new patients
Ora Orthopedics, PC Past Accepting new patients

Locations

3385 Dexter Ct
Ste 203
Davenport, IA 52807
Phone (563) 332-9312

4451 E 53rd St
Ste 200
Davenport, IA 52807
Phone (563) 362-0016

850 43rd Ave
Ste 100
Moline, IL 61265
Phone (309) 743-2070

Organizations & group practices 3

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": "1329868800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329868800000",
    "number": "1750654604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 43RD AVE",
            "address_2": "SUITE 100",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612658401",
            "telephone_number": "309-743-2070",
            "fax_number": "309-743-2073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3385 DEXTER CT",
            "address_2": "SUITE 203",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528073494",
            "telephone_number": "563-332-9312",
            "fax_number": "563-332-9316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRIES",
        "first_name": "TARA",
        "middle_name": "MARIE",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-22",
        "last_updated": "2012-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IA",
            "license": "03375",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "BURMEISTER",
            "middle_name": "MARIE",
            "credential": "MPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2012; 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.