Christopher Derek Rose, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

0000006473 Issued in TN

Practice address

520 Cook St Ste D
Madisonville, TN 37354-1533

Phone

(423) 442-1440

NPI assigned

May 21, 2018

Last updated

May 21, 2018By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Daniel Long

  dba Fyzical Therapy and Balance Centers

  • Specialist
  • Madisonville, TN
  • NPI 1972686194
  NPD (past)
• Prisma Health - Blount Memorial Hospital Inc.

  dba Blount Memorial Hospital

  • General Acute Care Hospital
  • Maryville, TN
  • NPI 1619939071
  NPD (past)

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

{
    "created_epoch": "1526860800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1526860800000",
    "number": "1417448911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "145 WARREN ST APT 16",
            "city": "MADISONVILLE",
            "state": "TN",
            "postal_code": "373541062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 COOK ST STE D",
            "city": "MADISONVILLE",
            "state": "TN",
            "postal_code": "373541533",
            "telephone_number": "423-442-1440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROSE",
        "first_name": "CHRISTOPHER",
        "middle_name": "DEREK",
        "name_prefix": "Mr.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-05-21",
        "last_updated": "2018-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "0000006473",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Parkwest Medical Center (Peninsula Outpatient Center)
• Gregory Preston, O.T.R/L
• Prisma Health - Blount Memorial Hospital Inc.
• R Andrew Turner DDS MDS PLLC
• Margaret A Ramsey, D.D.S
• Crystal A Russell
• S&T Beverley, LLC
• Safe Haven Counseling LLC
• Cheryl F Scarlett
• Shannon R Scoggins, P.T.

• Physical Therapy Assistant in Madisonville, TN
• Providers in Madisonville, TN by specialty
• Physical Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2018; 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.