Active NPI
Virginia Renee Lattus, PT
- Physical Therapist
- Union City, TN
National Provider Identifier
1215936760
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT5883
- Practice address
- 1720 E Reelfoot Ave
Union City, TN 38261-6047 - Phone
- (731) 884-0744
- Fax
- (731) 884-0748
- NPI assigned
- Jul 18, 2005
- Sex
- Female
- Sole proprietor
- No
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 | PT5883 | TN | Primary |
Addresses
Primary practice location
1720 E Reelfoot Ave
Union City, TN 38261-6047
Mailing address
5028 Old Pierce Rd
South Fulton, TN 38257-8108
Phone (731) 884-0744
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041217000824 | TN | Practitioner - Physical Therapist in Private Practice | 3476510751 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT5883 | TN | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agilitas USA Inc | Physical Therapist | Past | Accepting new patients |
| Kerry D. Friesen, M.D. PC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Internal Medicine Physician
- Chattanooga, TN
- NPI 1316052624
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1121644800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1215936760",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5028 OLD PIERCE RD",
"city": "SOUTH FULTON",
"state": "TN",
"postal_code": "382578108",
"telephone_number": "731-884-0744",
"fax_number": "731-884-0748"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1720 E REELFOOT AVE",
"city": "UNION CITY",
"state": "TN",
"postal_code": "382616047",
"telephone_number": "731-884-0744",
"fax_number": "731-884-0748"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LATTUS",
"first_name": "VIRGINIA",
"middle_name": "RENEE",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-07-18",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "PT5883",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Union City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.