P-72

Primary specialty

TaxiTaxonomy code 344600000X

Legal business name

P-72

Doing business as

Portect 72

Practice address

5878 Stewarts Ferry Pike # P72
Mt Juliet, TN 37122-4227

Phone

(615) 289-6216

Fax

(615) 547-2299

NPI assigned

Oct 12, 2023

Last updated

Oct 12, 2023By 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

Michael K Henderlight, AEMT

Title

Owner

Phone

(615) 289-6216

Specialties & licenses 1

Addresses

Other names 1

• Portect 72 Doing business as

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

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1306627609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5878 STEWARTS FERRY PIKE # P72",
            "city": "MT JULIET",
            "state": "TN",
            "postal_code": "371224227",
            "telephone_number": "615-289-6216",
            "fax_number": "615-547-2299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5878 STEWARTS FERRY PIKE # P72",
            "city": "MT JULIET",
            "state": "TN",
            "postal_code": "371224227",
            "telephone_number": "615-289-6216",
            "fax_number": "615-547-2299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "P-72",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-12",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "HENDERLIGHT",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "K",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "615-289-6216",
        "authorized_official_credential": "AEMT"
    },
    "taxonomies": [
        {
            "code": "344600000X",
            "taxonomy_group": "",
            "desc": "Taxi",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Portect 72",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Kelsey Otten, DPT
• Brian Overbeck, PT
• Brecken Elizabeth Overly, PA
• Candice Luther Owens, RBT
• Rachel Owens, IBCLC
• Joaquin Paez
• Elizabeth Page
• Kimberly Page, LCSW
• Lori Page, LPC-MHSP
• Paidion, LLC

• Taxi in Mount Juliet, TN
• Providers in Mount Juliet, TN by specialty
• Taxi in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 2023; 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.