Individual provider Active NPI

Vasil Kuchma, DPT

  • Physical Therapist
  • Cleveland, TN
National Provider Identifier
1134594088
Registry record updated Dec 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10533 Issued in TN
Practice address
3575 Keith St NW
Ste 205
Cleveland, TN 37312-4324
Phone
(423) 559-0444
Fax
(423) 559-0103
NPI assigned
Dec 3, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2015

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 10533 TN Primary

Addresses

Primary practice location

3575 Keith St NW
Ste 205
Cleveland, TN 37312-4324

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151222002856 TN Practitioner - Physical Therapist in Private Practice 4880995588 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
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)

4626 Hwy 58
Chattanooga, TN 37416-3013
Phone (423) 553-7972

5220 Park Ave
Suite 201
Memphis, TN 38119-3549
Phone (901) 683-9630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
10533TNMDPediatric Dentist

Practice roles

OrganizationSpecialtyStatusNew patients
Agilitas USA, Inc CurrentSince Dec 5, 2022 Accepting new patients
Agilitas USA Inc Physical Therapist Current Accepting new patients
Independent Physical Therapy, LLC Physical Therapist CurrentSince Dec 15, 2015 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Dec 5, 2022 Accepting new patients
Independent Physical Therapy CurrentSince Dec 15, 2015 Accepting new patients

Locations

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

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

3575 Keith St NW
Ste 205
Cleveland, TN 37312
Phone (423) 559-0444

2556 Dalton Pike SE
Cleveland, TN 37323
Phone (423) 476-4264

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

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

820 Scenic Hwy
Ste B
Lookout Mtn, TN 37350
Phone (423) 825-1393

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

8823 Production Ln
Ooltewah, TN 37363
Phone (423) 238-8923

Organizations & group practices 5

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": "1449100800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1449100800000",
    "number": "1134594088",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 KEITH ST NW",
            "address_2": "STE 205",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373124324",
            "telephone_number": "423-559-0444",
            "fax_number": "423-559-0103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KUCHMA",
        "first_name": "VASIL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-12-03",
        "last_updated": "2015-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "10533",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2015; 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.