NPIMap

Organization Active NPI

Physioplus LLC

  • Physical Therapy Clinic/Center
  • Memphis, TN
National Provider Identifier
1396750071
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PHYSIOPLUS LLC
Practice address
756 Ridge Lake Blvd
Suite 205
Memphis, TN 38120-9420
Phone
(901) 767-3667
Fax
(901) 767-3669
NPI assigned
Jul 30, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Carl Andrew Henderson, P.T.NPI 1952333080
Title
Chief Manager
Phone
(901) 767-3667

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X NU Primary

Addresses

Primary practice location

756 Ridge Lake Blvd
Suite 205
Memphis, TN 38120-9420

Mailing address

756 Ridge Lake Blvd
Suite 205
Memphis, TN 38120-9420
Phone (901) 767-3667

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050622000477 TN Part B Supplier - Clinic/Group Practice 4880639749 Receives reassigned benefits from 1 practitioner
Practice locations: Memphis, TN

National Provider Directory

National Provider Directory

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

Locations

756 Ridge Lake Blvd
Ste 205
Memphis, TN 38120
Phone (901) 292-3385

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1154217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1396750071",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "756 RIDGE LAKE BLVD",
            "address_2": "SUITE 205",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209420",
            "telephone_number": "901-767-3667",
            "fax_number": "901-767-3669"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "756 RIDGE LAKE BLVD",
            "address_2": "SUITE 205",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381209420",
            "telephone_number": "901-767-3667",
            "fax_number": "901-767-3669"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIOPLUS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HENDERSON",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "ANDREW",
        "authorized_official_title_or_position": "CHIEF MANAGER",
        "authorized_official_telephone_number": "901-767-3667",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.