Mary A Tackett, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT0000004711 Issued in TN

Practice address

7540 Dannaher Way
Suite 200
Powell, TN 37849-4013

Phone

(865) 947-4034

NPI assigned

Oct 6, 2008

Last updated

Oct 6, 2008By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Mary A Tackett Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1223251200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223251200000",
    "number": "1245481548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7540 DANNAHER WAY",
            "address_2": "SUITE 200",
            "city": "POWELL",
            "state": "TN",
            "postal_code": "378494013"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7540 DANNAHER WAY",
            "address_2": "SUITE 200",
            "city": "POWELL",
            "state": "TN",
            "postal_code": "378494013",
            "telephone_number": "865-947-4034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "MARY",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-06",
        "last_updated": "2008-10-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT0000004711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "TACKETT",
            "middle_name": "A",
            "credential": "PT",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 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.

Verify at the official NPI Registry.