Kelly R Bauer, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT0000006280 Issued in TN

Practice address

1125 Grove St
Ste 120
Loudon, TN 37774-3251

Phone

(865) 458-8080

Fax

(865) 458-4111

NPI assigned

Jul 25, 2007

Last updated

Jul 25, 2007By the provider in NPPES

Sex

Female

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

University of Tennessee, HSC, College of Medicine, 1999

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Healthpro Heritage Rehab and Fitness LLCGroup PAC ID 6507832573, 976 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Clinton, TN
  • NPI 1376073262
  Medicare reassignment Care Compare group NPD
• Additions Therapy, LLC

  • Rehabilitation Clinic/Center
  • Loudon, TN
  • NPI 1689622300
  NPD (past) Authorized official
• Healthpro Heritage Rehab & Fitness, LLC

  • Physical Therapist
  • Independence, MO
  • NPI 1871072462
  NPD

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

{
    "created_epoch": "1185321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185321600000",
    "number": "1912107129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 GROVE ST",
            "address_2": "STE 120",
            "city": "LOUDON",
            "state": "TN",
            "postal_code": "377743251",
            "telephone_number": "865-458-8080",
            "fax_number": "865-458-4111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 GROVE ST",
            "address_2": "STE 120",
            "city": "LOUDON",
            "state": "TN",
            "postal_code": "377743251",
            "telephone_number": "865-458-8080",
            "fax_number": "865-458-4111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUER",
        "first_name": "KELLY",
        "middle_name": "R",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-25",
        "last_updated": "2007-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT0000006280",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elizabeth Mary Amburn
• Sydni Arden
• Sarah Elliott Arnett, NBC-HWC
• Lisa L Baker, LCSW
• Bradley S Bauer, O.T.
• Brock Beeler, PT
• Dennis Howard Benedict, O.D.
• Richard Andrew Boehm, D.D.S.
• Gregory Eugene Bolt, PTA
• Kimberly Borneby, COTA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2007; 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.