Alexa Bradshaw
Individual provider Active NPI Physical Therapist · Hermitage, TN
NPI 1407689573 · NPPES record last updated Aug 23, 2024
Key facts
- NPI
- 1407689573
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 15460 (TN)
- Practice address
- 3810 Central Pike Ste 102
Hermitage, TN 37076-3495 - Phone
- (615) 915-5000
- NPI assigned
- Aug 23, 2024
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 4
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Results-Ast JV LLC
Practice addresses (Care Compare)
3810 Central Pike
Suite 102
Hermitage, TN 37076-3495
Phone (615) 915-5000
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241105003156 | TN | Practitioner - Physical Therapist in Private Practice | 2365976909 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15460 | TN | MD | Acute Care Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agilitas USA Inc | Physical Therapist | Current |
Accepting new patients |
| Agilitas USA, Inc | Physical Therapist | Current |
Accepting new patients |
| Results-Ast JV, LLC | Physical Therapist | Current |
Accepting new patients |
Locations
1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568
3810 Central Pike
Ste 102
Hermitage, TN 37076
Phone (615) 915-5000
5220 Park Ave
Ste 201
Memphis, TN 38119
Phone (901) 683-9630
2030 Cowan Hwy
Ste 1
Winchester, TN 37398
Phone (931) 968-1080
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 15460 | TN | Yes |
Addresses
Primary practice location
3810 Central Pike Ste 102
Hermitage, TN 37076-3495
Mailing address
1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 933-1260
Other providers in Hermitage, TN
- Molly Boring
- Camille Bourne
- Alisa Roseann Bowersock
- Rosetta Bradford
- Bradley Health Care, Inc
- Zachary Braver
- Stephanie Brewer
- Tara Brewer
- Kara Brock
- Hilary Jean Broussard
All providers in Hermitage, TN · Physical Therapist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 23, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.