Independent Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

INDEPENDENT PHYSICAL THERAPY, LLC

Doing business as

Benchmark PT

Practice address

1904 W Broadway Ave
Maryville, TN 37801-5402

Phone

(865) 983-8129

Fax

(865) 983-8293

NPI assigned

Sep 3, 2015

Last updated

Sep 3, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kevin Johanneson

Title

VP Revenue Cycle

Phone

(423) 238-8923

Specialties & licenses 3

Addresses

Other names 1

• BENCHMARK PT Doing business as

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Practitioners 1

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.

• Gabrielle Alyssa Broadbent, PT, DPT

  • Physical Therapist
  • Kodak, TN
  • NPI 1881043917
  NPD

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

{
    "created_epoch": "1441238400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1441238400000",
    "number": "1205204500",
    "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": "423-238-3417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1904 W BROADWAY AVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378015402",
            "telephone_number": "865-983-8129",
            "fax_number": "865-983-8293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-03",
        "last_updated": "2015-09-03",
        "status": "A",
        "authorized_official_last_name": "JOHANNESON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "VP REVENUE CYCLE",
        "authorized_official_telephone_number": "423-238-8923"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BENCHMARK PT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Jason D Hutchens, PHARM.D.
• Daniel Hutcheson
• Kristin E Igielski
• Independent Physical Therapy
• Independent Physical Therapy (BenchMark)
• Robert Vinsant Ingle, D.D.S.
• Robert Vinsant Ingle Jr., D.D.S.
• Sarah Ingram, CCC-SLP
• Tori Northcutt Ingram
• Cynthia Marie Irwin, LPC, MHSP

• Physical Therapist in Maryville, TN
• Providers in Maryville, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; 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.