Katy Scarlett Hackett, PT
Individual provider Active NPI Physical Therapist · Johnson City, TN
NPI 1457715872 · NPPES record last updated Mar 4, 2019
Key facts
- NPI
- 1457715872
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 10711 (TN)
- Practice address
- 3 Professional Park Dr Ste 10
Johnson City, TN 37604-6529 - Phone
- (423) 926-4331
- NPI assigned
- Apr 12, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 31
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Campbell Clinic, PC
Practice addresses (Care Compare)
1 Medical Park Blvd
Suite 300E
Bristol, TN 37620-7497
Phone (423) 434-6300
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20160506000571 | TN | Practitioner - Physical Therapist in Private Practice | 8527367994 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10711 | TN | MD | Pediatric Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Appalachian Orthopaedic Associates P C | Current |
Accepting new patients | |
| Campbell Clinic, PC | Current |
Accepting new patients | |
| Appalachian Orthopaedic Associates P C | Current |
Accepting new patients | |
| Appalachian Orthopaedic Associates P C | Current | Accepting new patients | |
| Healthpro Heritage Rehab & Fitness, LLC | Physical Therapist | Current |
Accepting new patients |
| Healthpro Heritage Rehab & Fitness, LLC | Physical Therapist | Current |
Accepting new patients |
| Campbell Clinic PC | Current |
Accepting new patients | |
| Appalachian Orthopaedic Associates, PC | Past | Accepting new patients |
Locations
1 Medical Park Blvd
Ste 300E
Bristol, TN 37620
Phone (423) 245-3161
105 Meadow View Rd
Ste 4
Bristol, TN 37620
Phone (423) 844-6935
960 S Seivers Blvd
Clinton, TN 37716
Phone (865) 270-3178
1500 W Elk Ave
Ste 102
Elizabethton, TN 37643
Phone (423) 282-5054
3 Professional Park Dr
Ste 10
Johnson City, TN 37604
Phone (423) 926-4331
3 Professional Park Dr
Ste 21
Johnson City, TN 37604
1400 S Germantown Rd
Memphis, TN 38138
Phone (901) 759-3111
Interoperability endpoints
- katy.hackett.1@1054.direct.athenahealth.com
- katy.hackett.1@1366.direct.athenahealth.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 10711 | TN | Yes |
| Physical Therapist | 225100000X | PT012416 | GA |
Addresses
Primary practice location
3 Professional Park Dr Ste 10
Johnson City, TN 37604-6529
Mailing address
3 Professional Park Drive
Johnson City, TN 37604
Phone (423) 926-4331
Other names
- Katy Scarlett Paredes
Other providers in Johnson City, TN
- Kelly P Gunter
- Chayadevie Guntupalli
- Hannah Christine Gustafson
- Sarah Gustafson
- Tuanzhu Ha
- Candice Nicole Hackler
- Tariq Z Haddadin
- Molly Ann Hagemeier
- Kelly Conyer Hagood
- Stephen Lloyd Haile
All providers in Johnson City, TN · Physical Therapist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 4, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.