Bill Issa Bakary Djire

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

13327 Issued in TN

Practice address

1201 Market Street, Suite a
Chattanoooga, TN 37402-7081

Phone

(423) 648-4490

Fax

(423) 648-4491

NPI assigned

May 3, 2021

Last updated

Apr 8, 2024By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Mercer University School of Medicine, 2018

Medicare assignment

May accept Medicare assignment

Group practices

Chattanooga Physical TherapyGroup PAC ID 8022256130, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Chattanooga Physical Therapy

  • Physical Therapy Clinic/Center
  • Chattanooga, TN
  • NPI 1659508604
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712534400000",
    "number": "1770166100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4477 PINERIDGE CIR",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303386540",
            "telephone_number": "404-532-8714"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 MARKET STREET, SUITE A",
            "city": "CHATTANOOOGA",
            "state": "TN",
            "postal_code": "374027081",
            "telephone_number": "423-648-4490",
            "fax_number": "423-648-4491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DJIRE",
        "first_name": "BILL",
        "middle_name": "ISSA BAKARY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-03",
        "last_updated": "2024-04-08",
        "certification_date": "2024-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "13327",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2024; 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.