Individual provider Active NPI

Jesup Fritsch

  • Physical Therapist
  • Clarksville, TN
National Provider Identifier
1447632344
Registry record updated Jun 17, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14311 Issued in TN
Practice address
2197 Madison St Ste 106
Clarksville, TN 37043-5253
Phone
(931) 503-1700
Fax
(931) 503-1798
NPI assigned
Jun 26, 2015
Last updated
Jun 17, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X TN
Physical Therapist 225100000X 14311 TN Primary

Addresses

Primary practice location

2197 Madison St Ste 106
Clarksville, TN 37043-5253

Mailing address

PO Box 306393
Nashville, TN 37230-6393
Phone (615) 373-1350

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, KY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20220628003083 TN Practitioner - Physical Therapist in Private Practice 2860871456 Reassigns benefits to 2 organizations
I20230510002608 KY Practitioner - Physical Therapist in Private Practice 2860871456 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Results-Ast JV LLCGroup PAC ID 4486066396, 390 clinicians

Practice addresses (Care Compare)

1725 Scottsville Rd
Bowling Green, KY 42104-3349
Phone (270) 467-9969

2197 Madison St
Suite 106
Clarksville, TN 37043-5253
Phone (931) 503-1700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14311TNMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy, LLC Physical Therapist CurrentSince Jul 11, 2022 Accepting new patients
Results-Ast JV, LLC Physical Therapist CurrentSince Jul 11, 2022 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1725 Scottsville Rd
Bowling Green, KY 42104
Phone (270) 467-9969

10634 Eagle Way
Hopkinsville, KY 42240
Phone (270) 220-0059

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

1011 Winn Way
Ste 110
Clarksville, TN 37043
Phone (931) 368-9082

2197 Madison St
Ste 106
Clarksville, TN 37043
Phone (931) 503-1700

1202 N Charles G Seivers Blvd
Ste A
Clinton, TN 37716
Phone (865) 457-0192

2030 Cowan Hwy
Ste 1
Winchester, TN 37398
Phone (931) 968-1080

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1435276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655424000000",
    "number": "1447632344",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306393",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306393",
            "telephone_number": "615-373-1350",
            "fax_number": "615-373-7116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2197 MADISON ST STE 106",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370435253",
            "telephone_number": "931-503-1700",
            "fax_number": "931-503-1798"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRITSCH",
        "first_name": "JESUP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-26",
        "last_updated": "2022-06-17",
        "certification_date": "2022-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "14311",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2022; 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.