Individual provider Active NPI

Andrew Marshall Hatch Jr., PT

  • Physical Therapist
  • Fort Payne, AL
National Provider Identifier
1437180809
Registry record updated Sep 23, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH3406 Issued in AL
Practice address
1102 Dekalb Plaza Blvd SW
Fort Payne, AL 35967-4868
Phone
(256) 997-9991
Fax
(256) 997-9950
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTH3406 AL Primary

Addresses

Primary practice location

1102 Dekalb Plaza Blvd SW
Fort Payne, AL 35967-4868

Mailing address

1102 Dekalb Plaza Blvd SW
Fort Payne, AL 35967-4868
Phone (256) 997-9991

Other identifiers 7

IdentifierTypeStateIssuer
26-0468379OtherTID
51596286OtherBCBS
1013114065OtherALNPI ORGANIZATION NUMBER
1437180809OtherNPI
510I650207OtherMEDICARE PTAN
PTH3406OtherALPHYSICAL THERAPY
51048428OtherALBCBS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050309000342 AL Practitioner - Physical Therapist in Private Practice 6608820022 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17495 Al Hwy 75
Henagar, AL 35978-5629
Phone (256) 657-3626

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PTH3406ALMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Advantage Physical Therapy, LLC CurrentSince Jul 30, 2021 Accepting new patients
Performance Group Cullman, LLC Physical Therapist Past Accepting new patients
Rehab Partners, P.C. PastSince Aug 3, 1999 Accepting new patients
Performance Group Albertville Physical Therapist Past Accepting new patients
Prohealth Physical Therapy, LLC Physical Therapist PastSince Jun 9, 2008 Accepting new patients

Locations

41340 AL Highway 75
Geraldine, AL 35974
Phone (256) 657-3626

17495 AL Highway 75
Henagar, AL 35978
Phone (256) 657-3626

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316736000000",
    "number": "1437180809",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 DEKALB PLAZA BLVD SW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359674868",
            "telephone_number": "256-997-9991",
            "fax_number": "256-997-9950"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1102 DEKALB PLAZA BLVD SW",
            "city": "FORT PAYNE",
            "state": "AL",
            "postal_code": "359674868",
            "telephone_number": "256-997-9991",
            "fax_number": "256-997-9950"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HATCH",
        "first_name": "ANDREW",
        "middle_name": "MARSHALL",
        "name_suffix": "Jr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2011-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH3406",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TID",
            "identifier": "26-0468379",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51596286",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI ORGANIZATION NUMBER",
            "identifier": "1013114065",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NPI",
            "identifier": "1437180809",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "510I650207",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY",
            "identifier": "PTH3406",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51048428",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Payne, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2011; 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.