Individual provider Active NPI

Liza Marie Manalo Pabalate, PT

  • Physical Therapist
  • Memphis, TN
National Provider Identifier
1184873713
Registry record updated Sep 18, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
02337 Issued in TN
Practice address
3624 Austin Peay Hwy
Suite 1
Memphis, TN 38128-3776
Phone
(901) 372-7324
Fax
(901) 372-7326
NPI assigned
Sep 18, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 02337 TN Primary

Addresses

Primary practice location

3624 Austin Peay Hwy
Suite 1
Memphis, TN 38128-3776

Mailing address

3624 Austin Peay Hwy
Suite 1
Memphis, TN 38128-3776
Phone (901) 372-7324

Other names 1

  • Liza Pabalate Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040602000674 TN Practitioner - Physical Therapist in Private Practice 0345221271 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
02337TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Dec 1, 2021 Accepting new patients
Aegis Group Practice LLC Physical Therapist CurrentSince Oct 2, 2023 Accepting new patients
Ave Maria Home Physical Therapist CurrentSince Oct 25, 2021 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Dec 1, 2021 Accepting new patients
Aegis Group Practice LLC Physical Therapist Current Accepting new patients
TLC Medical & Physical Therapy Clinic,LLC Current Accepting new patients
Aegis Group Practice LLC Physical Therapist CurrentSince Oct 2, 2023 Accepting new patients
Rehabdynamix SC Physical Therapist Past Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

3345 Kirby Whitten Rd
Bartlett, TN 38134
Phone (901) 245-4395

2805 Charles Bryan Rd
Bartlett, TN 38134
Phone (901) 386-3211

960 S Seivers Blvd
Clinton, TN 37716
Phone (865) 270-3178

3624 Austin Peay Hwy
Ste 1
Memphis, TN 38128
Phone (901) 372-7324

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1221696000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221696000000",
    "number": "1184873713",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3624 AUSTIN PEAY HWY",
            "address_2": "SUITE 1",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381283776",
            "telephone_number": "901-372-7324",
            "fax_number": "901-372-7326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3624 AUSTIN PEAY HWY",
            "address_2": "SUITE 1",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381283776",
            "telephone_number": "901-372-7324",
            "fax_number": "901-372-7326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PABALATE",
        "first_name": "LIZA MARIE",
        "middle_name": "MANALO",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-18",
        "last_updated": "2008-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "02337",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LIZA",
            "last_name": "PABALATE",
            "credential": "PT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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 Sep 18, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.