William Michael Record, PT, DPT, LAT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11759 Issued in TN

Practice address

103 Main St S
MC Kenzie, TN 38201-2200

Phone

(731) 393-8000

Fax

(731) 393-8100

NPI assigned

Jun 5, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Dynamix Physical Therapy LLCGroup PAC ID 5193873933, 46 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Dynamix Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Milan, TN
  • NPI 1669619268
  Medicare reassignment Care Compare group NPD
• Kerry D. Friesen, M.D. PC

  • Internal Medicine Physician
  • Chattanooga, TN
  • NPI 1316052624
  NPD (past)
• Dynamix Physical Therapy LLC

  • Physical Therapist
  • Corinth, MS
  • NPI 1962295576
  NPD (past)

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

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1326530379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "36 CARTHAGE RD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383059438",
            "telephone_number": "731-414-6961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "103 MAIN ST S",
            "city": "MC KENZIE",
            "state": "TN",
            "postal_code": "382012200",
            "telephone_number": "731-393-8000",
            "fax_number": "731-393-8100"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2060 Rhino Crossing",
            "address_purpose": "LOCATION",
            "city": "Milan",
            "state": "TN",
            "postal_code": "38358",
            "country_code": "US",
            "telephone_number": "731-613-2214",
            "fax_number": "731-613-2215",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RECORD",
        "first_name": "WILLIAM",
        "middle_name": "MICHAEL",
        "credential": "PT, DPT, LAT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "11759",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shelby Jo Priddy Chapman, PA-C
• Rilladean Skye Prince, PT, DPT
• Tera L Pruett, COTA/L
• Sara-Linda Puckett, COTA/L
• Kelly E Rawls, PHYSICIAN ASSISTANT
• Rebecca Lee Redmond, LDO
• Rehab America, Inc
• Delia Grace Rhinehart, CFNP, CRNA
• Kadin Ricciardi
• Robert Riley

• Physical Therapist in MC Kenzie, TN
• Providers in MC Kenzie, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; 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.