Individual provider Active NPI

Jessica Elizabeth Brackett, PT

  • Physical Therapist
  • Knoxville, TN
National Provider Identifier
1023279072
Registry record updated Oct 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8066 Issued in TN
Practice address
1819 W Clinch Ave Ste 106
Knoxville, TN 37916-2435
Phone
(865) 633-0259
Fax
(865) 524-5407
NPI assigned
Jun 23, 2008
Last updated
Oct 18, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2022

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 8066 TN Primary

Addresses

Primary practice location

1819 W Clinch Ave Ste 106
Knoxville, TN 37916-2435

Mailing address

PO Box 9118
Minneapolis, MN 55480-9118
Phone (865) 694-7725

Other practice location 1

9430 Park West Blvd Ste 230
Knoxville, TN 37923-4204
Phone (865) 560-8550

Other identifiers 1

IdentifierTypeStateIssuer
1505589MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080710000732 TN Practitioner - Physical Therapist in Private Practice 1052483831 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians

Practice addresses (Care Compare)

7333 Chapman Hwy
Knoxville, TN 37920-6681
Phone (865) 862-3823

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8066TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Orthopaedic Clinics PC CurrentSince Jun 16, 2008 Accepting new patients
Tennessee Orthopaedic Alliance PA CurrentSince Jan 1, 2021 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Dec 5, 2022 Accepting new patients
Tennessee Orthopaedic Alliance PA CurrentSince Jan 1, 2021 Accepting new patients
Tennessee Orthopaedic Clinics PC CurrentSince Jun 16, 2008 Accepting new patients
Tennessee Orthopaedic Clinics PC Current Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Dec 5, 2022 Accepting new patients

Locations

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

3493 Veterans Dr N
Ste D
Huntingdon, TN 38344
Phone (731) 209-4444

1819 Clinch Ave
Ste 106
Knoxville, TN 37916
Phone (865) 524-5365

7333 Chapman Hwy
Knoxville, TN 37920
Phone (865) 862-3823

7558 Mountain Grove Dr
Knoxville, TN 37920
Phone (865) 577-8244

9129 Cross Park Dr
Ste 101
Knoxville, TN 37923
Phone (865) 694-7725

9430 Park West Blvd
Ste 230
Knoxville, TN 37923
Phone (865) 560-8550

576 Fort Loudoun Med Center Dr
Ste 100
Lenoir City, TN 37772
Phone (865) 988-8667

5220 Park Ave
Ste 201
Memphis, TN 38119
Phone (901) 683-9630

8 City Blvd
Ste 100
Nashville, TN 37209
Phone (615) 263-0155

988 Oak Ridge Tpke
Ste 100
Oak Ridge, TN 37830
Phone (865) 483-8478

Organizations & group practices 7

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": "1214179200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666051200000",
    "number": "1023279072",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 9118",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554809118",
            "telephone_number": "865-694-7725",
            "fax_number": "865-524-5047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1819 W CLINCH AVE STE 106",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379162435",
            "telephone_number": "865-633-0259",
            "fax_number": "865-524-5407"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9430 Park West Blvd Ste 230",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379234204",
            "country_code": "US",
            "telephone_number": "865-560-8550",
            "fax_number": "865-560-8551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRACKETT",
        "first_name": "JESSICA",
        "middle_name": "ELIZABETH",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-23",
        "last_updated": "2022-10-18",
        "certification_date": "2022-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "8066",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1505589",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2022; 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.