Individual provider Active NPI

Anna Jugan, PT

  • Pediatric Physical Therapist
  • Kingston, TN
National Provider Identifier
1497987382
Registry record updated Aug 18, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
896 Issued in TN
Practice address
187 Gallaher Rd
Kingston, TN 37763-4721
Phone
(865) 376-4620
Fax
(865) 376-1759
NPI assigned
Aug 11, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 18, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist 2251P0200X 896 TN Primary

Addresses

Primary practice location

187 Gallaher Rd
Kingston, TN 37763-4721

Mailing address

187 Gallaher Rd
Kingston, TN 37763-4721
Phone (865) 376-4620

Other identifiers 1

IdentifierTypeStateIssuer
896OtherTNPT LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
896TNMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Jane K Bryant Past Accepting new patients

Organizations & group practices 1

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": "1249948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1250553600000",
    "number": "1497987382",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "187 GALLAHER RD",
            "city": "KINGSTON",
            "state": "TN",
            "postal_code": "377634721",
            "telephone_number": "865-376-4620",
            "fax_number": "865-376-1759"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "187 GALLAHER RD",
            "city": "KINGSTON",
            "state": "TN",
            "postal_code": "377634721",
            "telephone_number": "865-376-4620",
            "fax_number": "865-376-1759"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JUGAN",
        "first_name": "ANNA",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-08-11",
        "last_updated": "2009-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "TN",
            "license": "896",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE NUMBER",
            "identifier": "896",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kingston, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.