Platinum Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT962 Issued in TN

Legal business name

PLATINUM PHYSICAL THERAPY, LLC

Practice address

1816 N Washington St
Suite 101
Tullahoma, TN 37388

Phone

(931) 393-2378

Fax

(931) 455-9983

NPI assigned

Jun 5, 2008

Organization subpart

No

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

Authorized official

Name

Gary R Stevens, DO

Title

Partner

Phone

(931) 393-2378

Specialties & licenses 2

Addresses

Other identifiers 3

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jamie Allison Word, PT

  • Physical Therapist
  • Tullahoma, TN
  • NPI 1245462803
  NPD (past)

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

{
    "created_epoch": "1212624000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1282694400000",
    "number": "1003075052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1816 N WASHINGTON ST",
            "address_2": "SUITE 101",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "37388",
            "telephone_number": "931-393-2378",
            "fax_number": "931-455-9983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1816 N WASHINGTON ST",
            "address_2": "SUITE 101",
            "city": "TULLAHOMA",
            "state": "TN",
            "postal_code": "37388",
            "telephone_number": "931-393-2378",
            "fax_number": "931-455-9983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PLATINUM PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-05",
        "last_updated": "2010-08-25",
        "status": "A",
        "authorized_official_last_name": "STEVENS",
        "authorized_official_first_name": "GARY",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PARTNER",
        "authorized_official_telephone_number": "931-393-2378",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT962",
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": "TN",
            "license": "OT3437",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD TENNESSEE",
            "identifier": "4207023",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3370356",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PALMETTO GBA-RAILROAD MEDICARE",
            "identifier": "DQ1710",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Marilyn Derden Phelps, LCSW
• Sally Elizabeth Phillips
• Deborah Cheryl Pickel
• Alice J Piech, PT
• Kari S Pitchko, CPNP
• Terri L Ponder, LCSW
• Susan Whitney Popovich, COTA
• Premier Neurosurgery & Spine Ctr
• Judy D Price
• Tina M Price

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.