Organization Active NPI

Pro Care Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Knoxville, TN
National Provider Identifier
1427678069
Registry record updated Jul 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
PRO CARE PHYSICAL THERAPY, LLC
Practice address
105 Center Park Dr Ste 101
Knoxville, TN 37922-3470
Phone
(865) 335-3035
NPI assigned
Apr 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2020

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

Authorized official

Name
Dr. Lauren Elizabeth Macguire Bolling, DPTNPI 1265581870
Title
Manager and Sole Member
Phone
(865) 591-8477

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 Primary

Addresses

Primary practice location

105 Center Park Dr Ste 101
Knoxville, TN 37922-3470

Mailing address

2623 Brooke Willow Blvd
Knoxville, TN 37932-1894
Phone (865) 591-8477

Other practice location 1

2623 Brooke Willow Blvd
Knoxville, TN 37932-1894
Phone (865) 591-8477

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200521000886 TN Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4981035268 Receives reassigned benefits from 2 practitioners
Practice locations: Knoxville, TN

National Provider Directory

National Provider Directory

Locations

105 Center Park Dr
Ste 101
Knoxville, TN 37922
Phone (865) 335-3035

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1587600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1595980800000",
    "number": "1427678069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2623 BROOKE WILLOW BLVD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379321894",
            "telephone_number": "865-591-8477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 CENTER PARK DR STE 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379223470",
            "telephone_number": "865-335-3035"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2623 Brooke Willow Blvd",
            "address_purpose": "LOCATION",
            "city": "Knoxville",
            "state": "TN",
            "postal_code": "379321894",
            "country_code": "US",
            "telephone_number": "865-591-8477",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PRO CARE PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-04-23",
        "last_updated": "2020-07-29",
        "certification_date": "2020-07-29",
        "status": "A",
        "authorized_official_last_name": "MACGUIRE BOLLING",
        "authorized_official_first_name": "LAUREN",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "MANAGER AND SOLE MEMBER",
        "authorized_official_telephone_number": "865-591-8477",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.