Active NPI
Dana Lee Slack, PT
- Physical Therapist
- Cleveland, TN
National Provider Identifier
1003041120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT8340
- Practice address
- 102 Dunhill PL NW Ste B
Cleveland, TN 37311-3890 - Phone
- (423) 559-0444
- Fax
- (423) 559-0103
- NPI assigned
- May 19, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT8340 | TN | Primary |
Addresses
Primary practice location
102 Dunhill PL NW Ste B
Cleveland, TN 37311-3890
Mailing address
8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT8340 | TN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1242691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1242691200000",
"number": "1003041120",
"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": "423-238-3473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "102 DUNHILL PL NW STE B",
"city": "CLEVELAND",
"state": "TN",
"postal_code": "373113890",
"telephone_number": "423-559-0444",
"fax_number": "423-559-0103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SLACK",
"first_name": "DANA",
"middle_name": "LEE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-05-19",
"last_updated": "2009-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "PT8340",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cleveland, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.