Independent Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

INDEPENDENT PHYSICAL THERAPY

Practice address

80 Miller Ave Ste 104
Crossville, TN 38555-6056

Phone

(931) 787-1244

Fax

(931) 787-1245

NPI assigned

May 22, 2008

Organization subpart

No

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

Authorized official

Name

Troy Bage

Title

President

Phone

(423) 238-7217

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• BenchMark Physical Therapy Other name

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Robert James Colasso, PT

  • Physical Therapist
  • Shelbyville, TN
  • NPI 1851653596
  NPD
• Suncica Sunshine Svalina, DPT

  • Physical Therapist
  • Athens, TN
  • NPI 1194149831
  NPD
• Kori N Eytcheson, MPT

  • Physical Therapist
  • Chattanooga, TN
  • NPI 1811160302
  NPD (past)
• Aubrey Glenn Thompson Jr., PT

  • Physical Therapist
  • Crossville, TN
  • NPI 1568636397
  NPD (past)

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

{
    "created_epoch": "1211414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1211414400000",
    "number": "1336306752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 MILLER AVE STE 104",
            "city": "CROSSVILLE",
            "state": "TN",
            "postal_code": "385556056",
            "telephone_number": "931-787-1244",
            "fax_number": "931-787-1245"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-05-22",
        "last_updated": "2008-05-22",
        "status": "A",
        "authorized_official_last_name": "BAGE",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-238-7217"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0446652",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBST GROUP #",
            "identifier": "3156797",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BenchMark Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Jonathan Scott Hull, LPC
• Robin Browning Hull, ED.S., L.P.C.
• Piper Black Hutchinson, DNP, FNP-C
• Edwin Charles Hyne Jr., LMT
• Milady Orcullo Igot, PT
• Independent Physical Therapy LLC
• Independent Physical Therapy LLC
• Infinity Dental PLLC
• Alexie Inman, OTR/L
• Innovative Restorations LLC

• All providers in Crossville, TN
• Physical Therapy Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 22, 2008; 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.