Mark Kevin Viduya

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

012542 Issued in CT

Practice address

4249 Highway 411 Ste 4
Madisonville, TN 37354-1544

Phone

(423) 442-4034

Fax

(423) 442-6463

NPI assigned

Mar 15, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Agilitas USA, IncGroup PAC ID 3375454648, 812 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 and National Provider Directory roles.

• Agilitas USA Inc

  • Physical Therapy Clinic/Center
  • Hixson, TN
  • NPI 1962417444

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Agilitas USA, Inc

  • Physical Therapy Clinic/Center
  • Chattanooga, TN
  • NPI 1518695436

  Physical Therapist

  NPD

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785801600000",
    "number": "1407557580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1580 SAWGRASS CORPORATE PKWY STE 200",
            "city": "SUNRISE",
            "state": "FL",
            "postal_code": "333232869",
            "telephone_number": "954-739-4247"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4249 HIGHWAY 411 STE 4",
            "city": "MADISONVILLE",
            "state": "TN",
            "postal_code": "373541544",
            "telephone_number": "423-442-4034",
            "fax_number": "423-442-6463"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VIDUYA",
        "first_name": "MARK",
        "middle_name": "KEVIN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-15",
        "last_updated": "2026-08-04",
        "certification_date": "2026-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "012542",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brooke Torbett, FNP
• Tanner Trent, DDS
• Laura Jo Vacheresse, LCSW
• Julie Vasquez
• Andrew Venable, PA
• Nicole Vonaschwege, DC
• Wal-Mart Stores East LP
• Wal-Mart Stores East, LP
• Walgreen Co
• Mary J Walker, APN

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2026; 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.