Specialized Physical Therapy, PLLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

SPECIALIZED PHYSICAL THERAPY, PLLC

Practice address

6025 Lee Hwy Ste 445
Chattanooga, TN 37421-2966

Phone

(423) 499-4043

Fax

(423) 499-4045

NPI assigned

Apr 22, 2011

Organization subpart

No

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

Authorized official

Name

Dr. Kenneth Luke Keach, PT, DPTNPI 1114132560

Title

Physical Therapist, Owner

Phone

(423) 364-6183

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kenneth Luke Keach, PT

  • Physical Therapist
  • Chattanooga, TN
  • NPI 1114132560
  Medicare reassignment Care Compare group NPD Authorized official
• Kristin Parnell, PT

  • Physical Therapist
  • Chattanooga, TN
  • NPI 1487107116
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1303430400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1493337600000",
    "number": "1265723464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6025 LEE HWY STE 445",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212966",
            "telephone_number": "423-499-4043",
            "fax_number": "423-499-4045"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6025 LEE HWY STE 445",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212966",
            "telephone_number": "423-499-4043",
            "fax_number": "423-499-4045"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPECIALIZED PHYSICAL THERAPY, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-04-22",
        "last_updated": "2017-04-28",
        "status": "A",
        "authorized_official_last_name": "KEACH",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "LUKE",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST, OWNER",
        "authorized_official_telephone_number": "423-364-6183",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003185128A",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1524405",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Chattanooga, TN
• Providers in Chattanooga, TN by specialty
• Physical Therapy Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2017; 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.