NPIMap

Organization Active NPI

Tricare Rehabilitation Services, Inc.

  • Rehabilitation Clinic/Center
  • Gallatin, TN
National Provider Identifier
1164612248
Registry record updated Nov 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
License
446693 Issued in TN
Legal business name
TRICARE REHABILITATION SERVICES, INC.
Practice address
258 E Main St
Gallatin, TN 37066-2961
Phone
(615) 452-9686
Fax
(615) 452-9652
NPI assigned
Jul 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2009

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

Authorized official

Name
Mr. Babloo Chacko
Title
Administrator
Phone
(615) 452-9686

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Rehabilitation Clinic/Center 261QR0400X 446693 TN Primary

Addresses

Primary practice location

258 E Main St
Gallatin, TN 37066-2961

Mailing address

258 E Main St
Gallatin, TN 37066-2961
Phone (615) 452-9686

Other identifiers 1

IdentifierTypeStateIssuer
3370144MedicaidTN

National Provider Directory

National Provider Directory

Locations

258 E Main St
Gallatin, TN 37066
Phone (615) 230-3000

253 W Main St
#201
Gallatin, TN 37066
Phone (615) 452-9686

253 W Main St
Ste 201
Gallatin, TN 37066
Phone (615) 452-9686

919 W Main St
Ste M1
Hendersonville, TN 37075
Phone (615) 824-7600

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258070400000",
    "number": "1164612248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "258 E MAIN ST",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370662961",
            "telephone_number": "615-452-9686",
            "fax_number": "615-452-9652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "258 E MAIN ST",
            "city": "GALLATIN",
            "state": "TN",
            "postal_code": "370662961",
            "telephone_number": "615-452-9686",
            "fax_number": "615-452-9652"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRICARE REHABILITATION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-26",
        "last_updated": "2009-11-13",
        "status": "A",
        "authorized_official_last_name": "CHACKO",
        "authorized_official_first_name": "BABLOO",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "615-452-9686",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "TN",
            "license": "446693",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3370144",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gallatin, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.