Bruce Lee Forsyth, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT1114031 Issued in TX

Practice address

3700 Cross Park Dr
Bryan, TX 77802-4137

Phone

(979) 774-9958

Fax

(979) 774-9978

NPI assigned

Sep 8, 2005

Last updated

Jan 11, 2017By 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

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WY

Enrollment records 1

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.

• Four Pines Physical Therapy PC

  • Physical Therapist
  • Jackson, WY
  • NPI 1013090539
  Medicare reassignment NPD
• Therapy Works LLC

  • Occupational Therapist
  • Thayne, WY
  • NPI 1639219983
  Medicare reassignment NPD
• Four Pines Physical Therapy Limited Partnership

  • Physical Therapist
  • Jackson, WY
  • NPI 1578373890
  NPD
• Therapy Works, LLC

  • Durable Medical Equipment & Medical Supplies
  • Thayne, WY
  • NPI 1568766400
  NPD

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

{
    "created_epoch": "1126137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1992799605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3700 CROSS PARK DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778024137",
            "telephone_number": "979-774-9958",
            "fax_number": "979-774-9978"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3700 CROSS PARK DR",
            "city": "BRYAN",
            "state": "TX",
            "postal_code": "778024137",
            "telephone_number": "979-774-9958",
            "fax_number": "979-774-9978"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORSYTH",
        "first_name": "BRUCE",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-08",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "PT1114031",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "10061401",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mark Floyd, MD
• Shadell M Fluker
• McKinsey Ford, PHARM.D.
• Aaron Erwin Foreman, P.T.,C.P.O.
• Theresa Coronado Foreman, D.D.S.
• Jason Fort, LPC
• Cheryl Denice Foster, RN, FNP
• Essie Foster
• Suzan K Foster, PT
• Emily Christine Fotheringham

• Physical Therapist in Bryan, TX
• Providers in Bryan, TX by specialty
• Physical Therapist in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; 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.