Individual provider Active NPI

Dominic Worsowicz, PT

  • Physical Therapist
  • Knoxville, TN
National Provider Identifier
1497107858
Registry record updated Apr 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16324 Issued in TN
Practice address
4512 Chapman Hwy
Knoxville, TN 37920-4359
Phone
(865) 577-7779
NPI assigned
Jul 11, 2016
Last updated
Apr 8, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2025

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 16324 TN Primary
Physical Therapist 225100000X PT31291 FL

Addresses

Primary practice location

4512 Chapman Hwy
Knoxville, TN 37920-4359

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Other practice location 1

1325 San Marco Blvd Ste 102
Jacksonville, FL 32207-8549
Phone (904) 858-7045

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250422001609 TN Practitioner - Physical Therapist in Private Practice 8628363926 Reassigns benefits to 2 organizations

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
Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians

Practice addresses (Care Compare)

1202 N Charles G Seivers Blvd
Suite a
Clinton, TN 37716-3936
Phone (865) 457-0192

2838 Appalachian Hwy
Suite 2
Jacksboro, TN 37757-2829
Phone (423) 566-2356

5220 Park Ave
Suite 201
Memphis, TN 38119-3549
Phone (901) 683-9630

9305 S Northshore Dr
Knoxville, TN 37922-6548
Phone (865) 769-5278

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16324TNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Agilitas USA, Inc Physical Therapist CurrentSince May 5, 2025 Accepting new patients
Results-Ast JV, LLC Physical Therapist CurrentSince May 5, 2025 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince May 5, 2025 Accepting new patients
Jacksonville Orthopaedic Institute Inc Physical Therapist PastSince Aug 8, 2016 Accepting new patients

Locations

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

3493 Veterans Dr N
Ste D
Huntingdon, TN 38344
Phone (731) 209-4444

4512 Chapman Hwy
Knoxville, TN 37920
Phone (865) 277-7779

5220 Park Ave
Ste 201
Memphis, TN 38119
Phone (901) 683-9630

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

Organizations & group practices 4

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": "1468195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744070400000",
    "number": "1497107858",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4512 CHAPMAN HWY",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379204359",
            "telephone_number": "865-577-7779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1325 San Marco Blvd Ste 102",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "FL",
            "postal_code": "322078549",
            "country_code": "US",
            "telephone_number": "904-858-7045",
            "fax_number": "904-858-7047",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WORSOWICZ",
        "first_name": "DOMINIC",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-11",
        "last_updated": "2025-04-08",
        "certification_date": "2025-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "16324",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT31291",
            "primary": false
        }
    ],
    "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 Apr 8, 2025; 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.