Porter Place Rehab and Fitness LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

5365

Legal business name

PORTER PLACE REHAB AND FITNESS LLC

Doing business as

Porter Place Rehab & Fitness

Practice address

880 Jones Chapel Dr
Moscow, TN 38057-3331

Phone

(901) 581-4539

NPI assigned

Apr 28, 2013

Last updated

Apr 28, 2013By 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

Joni M. Robertson, PTNPI 1831524966

Title

Owner

Phone

(901) 581-4539

Specialties & licenses 1

Addresses

Other names 1

• Porter Place Rehab & Fitness Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Joni M. Robertson, PT

  • Physical Therapist
  • Ormond Beach, FL
  • NPI 1831524966
  Authorized official Same address or phone

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

{
    "created_epoch": "1367107200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367107200000",
    "number": "1356785703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "880 JONES CHAPEL DR",
            "city": "MOSCOW",
            "state": "TN",
            "postal_code": "380573331",
            "telephone_number": "901-581-4539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "880 JONES CHAPEL DR",
            "city": "MOSCOW",
            "state": "TN",
            "postal_code": "380573331",
            "telephone_number": "901-581-4539"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PORTER PLACE REHAB AND FITNESS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-28",
        "last_updated": "2013-04-28",
        "status": "A",
        "authorized_official_last_name": "ROBERTSON",
        "authorized_official_first_name": "JONI",
        "authorized_official_middle_name": "M.",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "901-581-4539",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": "5365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Porter Place Rehab & Fitness",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Shan McLean, RN, IBCLC
• Moscow Family Medical,LLC
• Renata Walton
• WLR Enterprise Inc

• Physical Therapy Clinic/Center in Moscow, TN
• Providers in Moscow, TN by specialty
• Physical Therapy Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2013; 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.