Individual provider Active NPI

Dorota Julita Nosarzewska, PTA

  • Physical Therapy Assistant
  • Crossville, TN
National Provider Identifier
1285895573
Registry record updated Jun 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA4066 Issued in TN
Practice address
29 Taylor Ave
Suite 205
Crossville, TN 38555-4527
Phone
(931) 456-5757
Fax
(931) 456-5533
NPI assigned
Jun 19, 2008
Last updated
Jun 19, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 19, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA4066 TN Primary

Addresses

Primary practice location

29 Taylor Ave
Suite 205
Crossville, TN 38555-4527

Mailing address

139 Hedgewood PT
Crossville, TN 38558-4514
Phone (931) 707-8312

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA4066TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Advanced Rehabilitation Center, PLLC PastSince May 2, 2018 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1213833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1213833600000",
    "number": "1285895573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 HEDGEWOOD PT",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385584514",
            "telephone_number": "931-707-8312",
            "fax_number": "931-456-5533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 TAYLOR AVE",
            "address_2": "SUITE 205",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385554527",
            "telephone_number": "931-456-5757",
            "fax_number": "931-456-5533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOSARZEWSKA",
        "first_name": "DOROTA",
        "middle_name": "JULITA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-19",
        "last_updated": "2008-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "PTA4066",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Crossville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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.