Agilitas USA Inc
Organization Active NPI Physical Therapy Clinic/Center · Lebanon, TN
NPI 1104970979 · NPPES record last updated Oct 10, 2019
Key facts
- NPI
- 1104970979
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Physical Therapy Clinic/Center 261QP2000X
- Legal business name
- AGILITAS USA INC
- Practice address
- 1420 W Baddour Pkwy Ste 120
Lebanon, TN 37087-1510 - Phone
- (615) 443-9036
- Fax
- (615) 443-9037
- NPI assigned
- Jan 22, 2007
- Organization subpart
- Yes
- Parent organization (as reported)
- AGILITAS USA INC
Authorized official
- Name
- Andrew Lange
- Title
- Cfo
- Phone
- (615) 373-1350
Other NPIs on the same Medicare enrollment 19
Practitioners 14
-
David Lee Ellis, PT
-
Macey Nicole Farnsworth, PT, DPT
-
Audrey Johnson, DPT
-
Misty McRae King, P.T.
-
Benjamin McChesney, DPT
-
Emily Pritchett, DPT
-
Michael Richard Ragan, PT, DPT
-
Logan Sims, DPT
-
Tyler Dean Stamper, DPT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041115000337 | TN | Part B Supplier - Clinic/Group Practice | 3375454648 |
Receives reassigned benefits from 623 practitioners 19 other NPIs on this enrollment This NPI is an additional NPI on the enrollment |
National Provider Directory
- Part of
- Results Physiotherapy
Locations
3760 Ocoee Pl NW
Ste 101
Cleveland, TN 37312
Phone (423) 336-3795
1680 Union Ave
Ste 106
Memphis, TN 38104
Phone (901) 969-0297
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Clinic/Center | 261QP2000X | Yes |
Addresses
Primary practice location
1420 W Baddour Pkwy Ste 120
Lebanon, TN 37087-1510
Mailing address
800 Crescent Centre Dr Ste 300
Franklin, TN 37067-7285
Phone (615) 373-1350
Other names
- Results Physiotherapy
NPI Registry JSON
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1570665600000",
"number": "1104970979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "800 CRESCENT CENTRE DR STE 300",
"city": "FRANKLIN",
"state": "TN",
"postal_code": "370677285",
"telephone_number": "615-373-1350",
"fax_number": "615-373-7116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1420 W BADDOUR PKWY STE 120",
"city": "LEBANON",
"state": "TN",
"postal_code": "370871510",
"telephone_number": "615-443-9036",
"fax_number": "615-443-9037"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "AGILITAS USA INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "AGILITAS USA INC",
"enumeration_date": "2007-01-22",
"last_updated": "2019-10-10",
"status": "A",
"authorized_official_last_name": "LANGE",
"authorized_official_first_name": "ANDREW",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "615-373-1350"
},
"taxonomies": [
{
"code": "261QP2000X",
"taxonomy_group": "",
"desc": "Clinic/Center, Physical Therapy",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Results Physiotherapy",
"code": "3",
"type": "Doing Business As"
}
]
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All providers in Lebanon, TN · Physical Therapy Clinic/Center in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 10, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.