Individual provider Active NPI

Beth Renee Ray, P.T.

  • Physical Therapist
  • Maryville, TN
National Provider Identifier
1306835251
Registry record updated Nov 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT19333 Issued in FL
Practice address
398 Olympia Drive
Maryville, TN 37804
Phone
(865) 233-1080
Fax
(865) 233-1081
NPI assigned
Oct 13, 2005
Last updated
Nov 8, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT19333 FL Primary

Addresses

Primary practice location

398 Olympia Drive
Maryville, TN 37804

Mailing address

398 Olympia Drive
Maryville, TN 37804
Phone (865) 233-1080

Other identifiers 4

IdentifierTypeStateIssuer
4011OtherFLSTAYWELL
Y909JOtherFLBCBS PROVIDER NUMBER
27001OtherFLWELLCARE PROVIDER
2288818OtherFLAETNA PROVIDER NUMBER

Other names 1

  • Beth Renee Denton Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20171026000890 TN Practitioner - Physical Therapist in Private Practice 1557637139 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT19333FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Oct 12, 2020 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Oct 12, 2020 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Jul 13, 2021 Accepting new patients
Functional Pathways Preferred of Tennessee LLC Physical Therapist CurrentSince Jul 1, 2022 Accepting new patients
Healthpro Heritage Rehab & Fitness, LLC Physical Therapist CurrentSince Jul 13, 2021 Accepting new patients
Therapy Plus LLC PastSince Jun 19, 2020 Accepting new patients
Medical Arts Rehabilitation Inc Physical Therapist Past Accepting new patients
Bay Area Physical Therapy LLC Physical Therapist Past Accepting new patients

Locations

110 Horizon Dr
#310
Raleigh, NC 27615

960 S Seivers Blvd
Clinton, TN 37716
Phone (865) 270-3178

10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2849

9649 Westland Dr
Knoxville, TN 37922
Phone (865) 223-6422

Organizations & group practices 8

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": "1129161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478563200000",
    "number": "1306835251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "398 OLYMPIA DRIVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "37804",
            "telephone_number": "865-233-1080",
            "fax_number": "865-233-1081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "398 OLYMPIA DRIVE",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "37804",
            "telephone_number": "865-233-1080",
            "fax_number": "865-233-1081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAY",
        "first_name": "BETH",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-13",
        "last_updated": "2016-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT19333",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STAYWELL",
            "identifier": "4011",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "Y909J",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE PROVIDER",
            "identifier": "27001",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PROVIDER NUMBER",
            "identifier": "2288818",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETH",
            "last_name": "DENTON",
            "middle_name": "RENEE",
            "credential": "P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Maryville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2016; 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.