Individual provider Active NPI

Anthony Robert Mancini, PT

  • Physical Therapist
  • Bowling Green, KY
National Provider Identifier
1124433891
Registry record updated Jan 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP014405T Issued in KY
Practice address
861 Fairview Ave Ste 102
Bowling Green, KY 42101-4991
Phone
(270) 783-8438
NPI assigned
Jun 21, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CP014405T KY Primary
Physical Therapist 225100000X 10043 TN

Addresses

Primary practice location

861 Fairview Ave Ste 102
Bowling Green, KY 42101-4991

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 497-0005

Other practice location 1

311 Congress Pkwy N
Ste 800
Athens, TN 37303-1699
Phone (423) 744-3555

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250129001587 KY Practitioner - Physical Therapist in Private Practice 1759509797 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Results-Ast JV LLCGroup PAC ID 4486066396, 390 clinicians

Practice addresses (Care Compare)

1861 Westen St
Suite B
Bowling Green, KY 42104-4151
Phone (270) 904-2753

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10043TNMDDentist
CP014405TKYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Agilitas USA Inc Physical Therapist CurrentSince Jan 6, 2025 Accepting new patients
Benchmark Physical Therapy of Ky LLC Physical Therapist CurrentSince Jan 6, 2025 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Jan 6, 2025 Accepting new patients
Drayer Physical Therapy Kentucky LLC Physical Therapist CurrentSince Jan 6, 2025 Accepting new patients
Drayer Physical Therapy Kentucky LLC Physical Therapist CurrentSince Jan 6, 2025 Accepting new patients
Agilitas USA Inc Past Accepting new patients

Locations

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

1725 Scottsville Rd
Bowling Green, KY 42104
Phone (270) 467-9969

861 Fairview Ave
Ste 102
Bowling Green, KY 42101
Phone (270) 783-8438

1588 Leestown Rd
Ste 120
Lexington, KY 40511
Phone (859) 317-8086

805 Blankenbaker Pkwy
Louisville, KY 40243
Phone (502) 253-0833

200 Codella Dr
Ste B
Winchester, KY 40391
Phone (859) 745-2152

311 Congress Pkwy N
Ste 800
Athens, TN 37303
Phone (423) 744-0890

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

1202 N Charles G Seivers Blvd
Ste A
Clinton, TN 37716
Phone (865) 457-0192

2030 Cowan Hwy
Ste 1
Winchester, TN 37398
Phone (931) 968-1080

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1403308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735862400000",
    "number": "1124433891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-497-0005",
            "fax_number": "423-954-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "861 FAIRVIEW AVE STE 102",
            "city": "BOWLING GREEN",
            "state": "KY",
            "postal_code": "421014991",
            "telephone_number": "270-783-8438"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "311 Congress Pkwy N",
            "address_2": "Ste 800",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "TN",
            "postal_code": "373031699",
            "country_code": "US",
            "telephone_number": "423-744-3555",
            "fax_number": "423-744-0849",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANCINI",
        "first_name": "ANTHONY",
        "middle_name": "ROBERT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-06-21",
        "last_updated": "2025-01-03",
        "certification_date": "2025-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "CP014405T",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "10043",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bowling Green, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2025; 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.