William David Van Eaton, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

210 Walmart Dr
Suite 100
Soddy Daisy, TN 37379-5022

Phone

(423) 332-9490

Fax

(423) 332-3817

NPI assigned

May 20, 2006

Last updated

Nov 19, 2010By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1148083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290124800000",
    "number": "1174577571",
    "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": "210 WALMART DR",
            "address_2": "SUITE 100",
            "city": "SODDY DAISY",
            "state": "TN",
            "postal_code": "373795022",
            "telephone_number": "423-332-9490",
            "fax_number": "423-332-3817"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VAN EATON",
        "first_name": "WILLIAM",
        "middle_name": "DAVID",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-20",
        "last_updated": "2010-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GROUP NUMBER",
            "identifier": "3156797",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0446652",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Soddy Daisy, TN
• Providers in Soddy Daisy, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; 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.