Individual provider Active NPI

Samuel Robert Bachman

  • Physical Therapist
  • Hixson, TN
National Provider Identifier
1316257413
Registry record updated Oct 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10229 Issued in TN
Practice address
1790 Hamill Rd
Hixson, TN 37343-5179
Phone
(423) 842-9322
Fax
(866) 591-0619
NPI assigned
Oct 7, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 15, 2014

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 10229 TN Primary

Addresses

Primary practice location

1790 Hamill Rd
Hixson, TN 37343-5179

Mailing address

1790 Hamill Rd
Hixson, TN 37343-5179
Phone (423) 842-9322

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150120001731 TN Practitioner - Physical Therapist in Private Practice 9638366727

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1790 Hamill Rd
Hixson, TN 37343-5179

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT37152CAMDLicensed Psychiatric Technician
033766NYMDMassage Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Torrance Health Association Inc Past Accepting new patients
Summit Physical Therapy Physical Therapist PastSince Oct 1, 2014 Accepting new patients
South Bay Orthopaedic Specialists Medical Center a Medical Partnership PastSince Oct 1, 2001 Accepting new patients

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1286409600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413331200000",
    "number": "1316257413",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1790 HAMILL RD",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373435179",
            "telephone_number": "423-842-9322",
            "fax_number": "866-591-0619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1790 HAMILL RD",
            "city": "HIXSON",
            "state": "TN",
            "postal_code": "373435179",
            "telephone_number": "423-842-9322",
            "fax_number": "866-591-0619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACHMAN",
        "first_name": "SAMUEL",
        "middle_name": "ROBERT",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-07",
        "last_updated": "2014-10-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "10229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hixson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.