Organization Active NPI

Redden Total Therapy-South, LLC

  • Physical Therapist
  • Jackson, TN
National Provider Identifier
1013151109
Registry record updated Jun 7, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6671 Issued in TN
Legal business name
REDDEN TOTAL THERAPY-SOUTH, LLC
Practice address
51 S Creek Dr
Jackson, TN 38301-7593
Phone
(731) 423-8700
Fax
(731) 423-8888
NPI assigned
Apr 21, 2009
Last updated
Jun 7, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 7, 2016

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

Authorized official

Name
Mr. Payton Michael Redden, PTNPI 1447257746
Title
President
Phone
(731) 512-0302

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 6671 TN Primary

Addresses

Primary practice location

51 S Creek Dr
Jackson, TN 38301-7593

Mailing address

1000 Greystone SQ
Jackson, TN 38305-3580
Phone (731) 512-0302

Other identifiers 1

IdentifierTypeStateIssuer
1514178MedicaidTN

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1385 S Highland Ave
Ste B3
Jackson, TN 38301
Phone (731) 423-8700

51 S Creek Dr
Jackson, TN 38301
Phone (731) 423-8700

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1240272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1465257600000",
    "number": "1013151109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 GREYSTONE SQ",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383053580",
            "telephone_number": "731-512-0302",
            "fax_number": "731-512-0319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "51 S CREEK DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383017593",
            "telephone_number": "731-423-8700",
            "fax_number": "731-423-8888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDDEN TOTAL THERAPY-SOUTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-04-21",
        "last_updated": "2016-06-07",
        "status": "A",
        "authorized_official_last_name": "REDDEN",
        "authorized_official_first_name": "PAYTON",
        "authorized_official_middle_name": "MICHAEL",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "731-512-0302",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "6671",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1514178",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2016; 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.