Antoinette Deshawn Parham

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

16168 Issued in TN

Practice address

3095 Eastend Dr
Humboldt, TN 38343-1902

Phone

(731) 824-2221

NPI assigned

Jan 17, 2025

Last updated

Jan 17, 2025By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Aegis Group Practice LLC

  • Physical Therapist
  • Germantown, TN
  • NPI 1174308647
  Medicare reassignment Care Compare group NPD
• Dynamix Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Milan, TN
  • NPI 1669619268
  Medicare reassignment NPD
• Aegis Group Practice LLC

  • Physical Therapist
  • Lexington, TN
  • NPI 1467261198
  NPD
• Aegis Group Practice LLC

  • Physical Therapist
  • Indian Harbour Beach, FL
  • NPI 1932072030
  NPD
• Kerry D. Friesen, M.D. PC

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

  dba MS Dynamix Physical Therapy

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

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

{
    "created_epoch": "1737072000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737072000000",
    "number": "1386455392",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14540 HIGHWAY 18 S",
            "city": "BOLIVAR",
            "state": "TN",
            "postal_code": "380083603",
            "telephone_number": "731-609-3196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3095 EASTEND DR",
            "city": "HUMBOLDT",
            "state": "TN",
            "postal_code": "383431902",
            "telephone_number": "731-824-2221"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "14540 Highway 18 S",
            "address_purpose": "LOCATION",
            "city": "Bolivar",
            "state": "TN",
            "postal_code": "380083603",
            "country_code": "US",
            "telephone_number": "731-609-3196",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARHAM",
        "first_name": "ANTOINETTE",
        "middle_name": "DESHAWN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-01-17",
        "last_updated": "2025-01-17",
        "certification_date": "2025-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "16168",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Myeyedr Optometry of Tennessee, LLC (MyEyeDr)
• Jeff Orgain
• David Michael Orwig, O D
• Gary Wayne Osborne, LPC, MHSP
• Otter Therapy and Vocational Services (Otter with Barb)
• Tammy Marisa Patton, LCSW, ED.D
• Justin Perry
• Sandi Peterson, COTA/L
• Megan Latimer Phillips, PA-C
• Brent Pierce, PHARMD.

• Physical Therapist in Humboldt, TN
• Providers in Humboldt, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2025; 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.