Marc Antonio Lange, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT23485 Issued in FL

Practice address

1000 Jackson Rd
Suite 100
Goodlettsville, TN 37072-3174

Phone

(407) 803-3067

Fax

(502) 213-4638

NPI assigned

Mar 1, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1330560000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330560000000",
    "number": "1518231091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 JACKSON RD",
            "address_2": "SUITE 100",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370723174",
            "telephone_number": "407-803-3067",
            "fax_number": "502-213-4638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 JACKSON RD",
            "address_2": "SUITE 100",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370723174",
            "telephone_number": "407-803-3067",
            "fax_number": "502-213-4638"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANGE",
        "first_name": "MARC",
        "middle_name": "ANTONIO",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-03-01",
        "last_updated": "2012-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT23485",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Molly Kathleen Kroeger, PA-C
• Kroger Limited Partnership I
• Jeff Lancaster
• Michael Lancaster
• Rudolph Dean Lang Jr., DDS
• Tori Langham
• Steven B Larson, MD
• Dat Thanh Tien Le, DMD
• Danielle Leatherman
• Chad Vernon Leclair, DPH

• Physical Therapist in Goodlettsville, TN
• Providers in Goodlettsville, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2012; 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.