Champion Physical Therapy LLC Halls

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

CHAMPION PHYSICAL THERAPY LLC HALLS

Practice address

109 Sugarfoot Way Ste 5
Pigeon Forge, TN 37863-6204

Phone

(865) 365-4800

Fax

(865) 365-4801

NPI assigned

Apr 20, 2018

Organization subpart

No

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

Authorized official

Name

Brad C. Roush

Title

Executive Vice President

Phone

(419) 221-6717

Specialties & licenses 1

Addresses

Other names 1

• CORA Physical Therapy - Pigeon Forge Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Champion Physical Therapy LLC Halls

  • Rehabilitation Clinic/Center
  • Morristown, TN
  • NPI 1013404409

  O20180925003397

  Same enrollment
• Champion Physical Therapy LLC Halls

  • Rehabilitation Clinic/Center
  • White Pine, TN
  • NPI 1285121673

  O20180925003397

  Same enrollment
• Champion Physical Therapy LLC Halls

  • Rehabilitation Clinic/Center
  • Knoxville, TN
  • NPI 1396232682

  O20180925003397

  Same enrollment
• Champion Physical Therapy, LLC

  • Rehabilitation Clinic/Center
  • Pigeon Forge, TN
  • NPI 1477151777

  O20180925003397

  Same enrollment
• Champion Physical Therapy, LLC

  • Rehabilitation Clinic/Center
  • Seymour, TN
  • NPI 1851999155

  O20180925003397

  Same enrollment

Locations

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

{
    "created_epoch": "1524182400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1583193600000",
    "number": "1083101463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1110 SHAWNEE RD",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458053529",
            "telephone_number": "419-221-6720",
            "fax_number": "419-222-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 SUGARFOOT WAY STE 5",
            "city": "PIGEON FORGE",
            "state": "TN",
            "postal_code": "378636204",
            "telephone_number": "865-365-4800",
            "fax_number": "865-365-4801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHAMPION PHYSICAL THERAPY LLC HALLS",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-20",
        "last_updated": "2020-03-03",
        "certification_date": "2020-03-03",
        "status": "A",
        "authorized_official_last_name": "ROUSH",
        "authorized_official_first_name": "BRAD",
        "authorized_official_middle_name": "C.",
        "authorized_official_title_or_position": "EXECUTIVE VICE PRESIDENT",
        "authorized_official_telephone_number": "419-221-6717"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORA Physical Therapy - Pigeon Forge",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Neiland Baerwald, DPH
• Shonda Alia Bailey, PHARMD
• Sandra McMahan Byrd, CFNP
• Caring Hearts and Hands of Tennessee, LLC
• Rodney G. Carter, M.D.
• Champion Physical Therapy, LLC
• Timothy Alan Cline II, ATC
• Brian Anthony Cooper, PHARMD
• Crescent Health
• Crescent Health

• All providers in Pigeon Forge, TN
• Rehabilitation Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.