Active NPI
Pathmavathi S Pentiah, PT
- Physical Therapist
- Benton, TN
National Provider Identifier
1154545978
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT0125
- Practice address
- 108 Lifestyle Way
Benton, TN 37307-3914 - Phone
- (423) 339-2320
- Fax
- (423) 339-2321
- NPI assigned
- Apr 12, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT0125 | TN | Primary |
Addresses
Primary practice location
108 Lifestyle Way
Benton, TN 37307-3914
Mailing address
PO Box 143
Collegedale, TN 37315-0143
Phone (423) 310-0555
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4129829 | Other | TN | BCBS PROVIDER NO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT0125 | TN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1154545978",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 143",
"city": "COLLEGEDALE",
"state": "TN",
"postal_code": "373150143",
"telephone_number": "423-310-0555",
"fax_number": "423-396-2387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "108 LIFESTYLE WAY",
"city": "BENTON",
"state": "TN",
"postal_code": "373073914",
"telephone_number": "423-339-2320",
"fax_number": "423-339-2321"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENTIAH",
"first_name": "PATHMAVATHI",
"middle_name": "S",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-04-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "PT0125",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS PROVIDER NO",
"identifier": "4129829",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Benton, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.