Individual provider Active NPI

Allen R Rhea Jr., P.T.

  • Orthopedic Physical Therapist
  • Johnson City, TN
National Provider Identifier
1417022989
Registry record updated Mar 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
3973 Issued in TN
Practice address
3 Professional Park Dr
Suite 10
Johnson City, TN 37604-6529
Phone
(423) 926-4331
Fax
(423) 926-5767
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 3973 TN Primary

Addresses

Primary practice location

3 Professional Park Dr
Suite 10
Johnson City, TN 37604-6529

Mailing address

3 Professional Park Dr
Suite 10
Johnson City, TN 37604-6529
Phone (423) 926-4331

Other identifiers 1

IdentifierTypeStateIssuer
3652431MedicaidTN

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
3973TNMDRegistered Dietitian

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1206403200000",
    "number": "1417022989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3 PROFESSIONAL PARK DR",
            "address_2": "SUITE 10",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046529",
            "telephone_number": "423-926-4331",
            "fax_number": "423-926-5767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3 PROFESSIONAL PARK DR",
            "address_2": "SUITE 10",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376046529",
            "telephone_number": "423-926-4331",
            "fax_number": "423-926-5767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHEA",
        "first_name": "ALLEN",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2008-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TN",
            "license": "3973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3652431",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2008; 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.