Active NPI
Michael Dubose, PT
- Physical Therapist
- Winchester, TN
National Provider Identifier
1174787626
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT0000008099
- Practice address
- 1397 S College St
Winchester, TN 37398-2414 - Phone
- (931) 962-3225
- Fax
- (931) 962-3103
- NPI assigned
- Jul 14, 2008
- Sex
- Male
- Sole proprietor
- Yes
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 | PT0000008099 | TN | Primary |
Addresses
Primary practice location
1397 S College St
Winchester, TN 37398-2414
Mailing address
1397 S College St
P. O. Box 4
Winchester, TN 37398-2414
Phone (931) 962-3225
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT0000008099 | TN | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1215993600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1215993600000",
"number": "1174787626",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1397 S COLLEGE ST",
"address_2": "P. O. BOX 4",
"city": "WINCHESTER",
"state": "TN",
"postal_code": "373982414",
"telephone_number": "931-962-3225",
"fax_number": "931-962-3103"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1397 S COLLEGE ST",
"city": "WINCHESTER",
"state": "TN",
"postal_code": "373982414",
"telephone_number": "931-962-3225",
"fax_number": "931-962-3103"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DUBOSE",
"first_name": "MICHAEL",
"credential": "PT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2008-07-14",
"last_updated": "2008-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "PT0000008099",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Winchester, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.