Active NPI
Trevor Ling, DPT, ATC
- Physical Therapist
- Memphis, TN
National Provider Identifier
1154413276
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 7772
- Practice address
- 5200 Park Ave
Suite 201
Memphis, TN 38119-3505 - Phone
- (901) 683-9630
- NPI assigned
- Sep 28, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305204477 | VA | |
| Physical Therapist | 225100000X | PT018410 | PA | |
| Physical Therapist | 225100000X | 22079 | MD | |
| Physical Therapist | 225100000X | 7772 | TN | Primary |
Addresses
Primary practice location
5200 Park Ave
Suite 201
Memphis, TN 38119-3505
Mailing address
2001 Mallory LN
Suite 201
Franklin, TN 37067-8233
Phone (615) 373-1350
Other identifiers 7
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3650036 | Medicaid | TN | |
| 686107 | Other | TN | UNITED HEALTHCARE GROUP PIN |
| 7772 | Other | TN | STATE LICENSE |
| 3080867 | Other | TN | BCBS GROUP PIN |
| 722076 | Other | TN | UNITED HEALTHCARE PIN |
| 01160826 | Other | TN | AMERIGROUP PIN |
| 4156211 | Other | TN | BCBS PIN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2005
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1045 Oakhaven Rd
Memphis, TN 38119-3811
Phone (901) 665-0500
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 22079 | MD | MD | Physical Therapist |
| PT018410 | PA | MD | Physical Therapist |
| 7772 | TN | MD | Physical Therapist |
| 2305204477 | VA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Peak Potential Physiotherapy and Wellness | Physical Therapist | Current | Accepting new patients |
Locations
930 W Poplar Ave
Ste 5
Collierville, TN 38017
Phone (901) 316-5456
1045 Oakhaven Rd
Memphis, TN 38119
Phone (901) 665-0500
Organizations & group practices 1
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.
-
- Physical Therapist
- Germantown, TN
- NPI 1881078723
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1228867200000",
"number": "1154413276",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2001 MALLORY LN",
"address_2": "SUITE 201",
"city": "FRANKLIN",
"state": "TN",
"postal_code": "370678233",
"telephone_number": "615-373-1350"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5200 PARK AVE",
"address_2": "SUITE 201",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381193505",
"telephone_number": "901-683-9630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LING",
"first_name": "TREVOR",
"credential": "DPT, ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-09-28",
"last_updated": "2008-12-10",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305204477",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "PA",
"license": "PT018410",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "MD",
"license": "22079",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "7772",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3650036",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE GROUP PIN",
"identifier": "686107",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE",
"identifier": "7772",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS GROUP PIN",
"identifier": "3080867",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE PIN",
"identifier": "722076",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMERIGROUP PIN",
"identifier": "01160826",
"state": "TN"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PIN",
"identifier": "4156211",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Memphis, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; 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.