Individual provider Active NPI

Bryn Lee Cloer, PT, DPT

  • Physical Therapist
  • Canton, GA
National Provider Identifier
1992234132
Registry record updated Jun 10, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT012903 Issued in GA
Practice address
6768 Hickory Flat Hwy Ste 110
Canton, GA 30115-9376
Phone
(770) 721-5767
Fax
(770) 345-0158
NPI assigned
Jun 10, 2017
Last updated
Jun 10, 2017By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2017

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 PT012903 GA Primary

Addresses

Primary practice location

6768 Hickory Flat Hwy Ste 110
Canton, GA 30115-9376

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171031002293 GA Practitioner - Physical Therapist in Private Practice 6608142914 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6768 Hickory Flat Hwy
Suite 110
Canton, GA 30115-9376
Phone (770) 721-5767

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT012903GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jun 7, 2017 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jun 7, 2017 Accepting new patients

Locations

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

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

6768 Hickory Flat Hwy
Ste 110
Canton, GA 30115
Phone (770) 704-8244

744 Noah Dr
Ste 107
Jasper, GA 30143
Phone (706) 253-3131

11490 Alpharetta Hwy
Ste 200
Roswell, GA 30076
Phone (770) 740-8592

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

8823 Production Ln
Ooltewah, TN 37363
Phone (423) 238-8923

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1497052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1497052800000",
    "number": "1992234132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-362-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6768 HICKORY FLAT HWY STE 110",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301159376",
            "telephone_number": "770-721-5767",
            "fax_number": "770-345-0158"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLOER",
        "first_name": "BRYN",
        "middle_name": "LEE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-10",
        "last_updated": "2017-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012903",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2017; 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.