Individual provider Active NPI

Noemi Ballesteros Barroga, P.T.

  • Physical Therapist
  • Jackson, TN
National Provider Identifier
1053600593
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT0000002179 Issued in TN
Practice address
781 Browns Church Rd
Jackson, TN 38305-9296
Phone
(731) 427-0058
NPI assigned
Apr 5, 2011
Last updated
Jun 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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 PT0000002179 TN Primary

Addresses

Primary practice location

781 Browns Church Rd
Jackson, TN 38305-9296

Mailing address

781 Browns Church Rd
Jackson, TN 38305-9296
Phone (901) 634-0421

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210722002381 TN Practitioner - Physical Therapist in Private Practice 3072916477 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

6605 N Quail Hollow Rd
Memphis, TN 38120-1323
Phone (901) 613-4064

960 S Charles G Seivers Blvd
Clinton, TN 37716-3882
Phone (865) 270-3178

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Jun 18, 2024 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Jun 18, 2024 Accepting new patients
TN Therapy Outsource, LLC Physical Therapist CurrentSince May 1, 2021 Accepting new patients
Physical Therapy of Jackson PC. PastSince Nov 1, 2001 Accepting new patients

Locations

960 S Seivers Blvd
Clinton, TN 37716
Phone (865) 270-3178

1118 Whitehall St
Jackson, TN 38301
Phone (731) 215-0949

1296 Union University Dr
Ste G
Jackson, TN 38305
Phone (865) 406-7675

2782 N Highland Ave
Ste A
Jackson, TN 38305
Phone (731) 664-1172

Organizations & group practices 4

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": "1301961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1053600593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "781 BROWNS CHURCH RD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383059296",
            "telephone_number": "901-634-0421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "781 BROWNS CHURCH RD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383059296",
            "telephone_number": "731-427-0058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BARROGA",
        "first_name": "NOEMI",
        "middle_name": "BALLESTEROS",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-04-05",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT0000002179",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 2, 2021; 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.