Individual provider Active NPI

Bertha Howell, PTA

  • Physical Therapy Assistant
  • Jackson, TN
National Provider Identifier
1356858799
Registry record updated Mar 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
1843 Issued in TN
Practice address
1725 S Highland Ave Ste D
Jackson, TN 38301-7767
Phone
(731) 421-8116
Fax
(731) 421-8127
NPI assigned
Jan 8, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 1843 TN Primary

Addresses

Primary practice location

1725 S Highland Ave Ste D
Jackson, TN 38301-7767

Mailing address

1804 Highway 45 Byp Ste 604
Jackson, TN 38305-4403
Phone (731) 660-7971

Other practice location 1

123 Front St
Henderson, TN 38340-2313
Phone (731) 989-0469

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
1843TNMDRegistered Respiratory Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Lift Therapy, Inc. Past Accepting new patients
Jackson Madison County General Hospital Past Accepting new patients

Organizations & group practices 2

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": "1515369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1356858799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1804 HIGHWAY 45 BYP STE 604",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383054403",
            "telephone_number": "731-660-7971",
            "fax_number": "731-660-8739"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1725 S HIGHLAND AVE STE D",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383017767",
            "telephone_number": "731-421-8116",
            "fax_number": "731-421-8127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "123 Front St",
            "address_purpose": "LOCATION",
            "city": "Henderson",
            "state": "TN",
            "postal_code": "383402313",
            "country_code": "US",
            "telephone_number": "731-989-0469",
            "fax_number": "731-989-3513",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HOWELL",
        "first_name": "BERTHA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-08",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "1843",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.