Individual provider Active NPI

Elizabeth A Hamm

  • Physical Therapist
  • Gray, TN
National Provider Identifier
1548429004
Registry record updated Mar 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
10130 Issued in TN
Practice address
406 Roy Martin Rd Ste 9
Gray, TN 37615-2245
Phone
(423) 477-1101
Fax
(423) 477-1102
NPI assigned
Jun 9, 2008
Last updated
Mar 29, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2023

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 PT24062 FL
Physical Therapist 225100000X 10130 TN Primary

Addresses

Primary practice location

406 Roy Martin Rd Ste 9
Gray, TN 37615-2245

Mailing address

406 Roy Martin Rd Ste 9
Gray, TN 37615-2245
Phone (423) 477-1101

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191122000752 WA Practitioner - Physical Therapist in Private Practice 4981036399
I20230419002495 TN Practitioner - Physical Therapist in Private Practice 4981036399 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Achieve Health and WellnessGroup PAC ID 2567644289, 5 clinicians

Practice addresses (Care Compare)

406 Roy Martin Rd
Suite 9
Gray, TN 37615-2245
Phone (423) 477-1101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT24062FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Achieve Health and Wellness Physical Therapist CurrentSince Jan 23, 2023 Accepting new patients
Leader Physical Therapy Limited Partnership Physical Therapist Past Accepting new patients
Achieve Health and Wellness PastSince Jan 23, 2023 Accepting new patients

Locations

406 Roy Martin Rd
Ste 9
Johnson City, TN 37615
Phone (423) 477-1101

110 E Center St
Kingsport, TN 37660
Phone (423) 477-1101

Organizations & group practices 3

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": "1212969600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680048000000",
    "number": "1548429004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 ROY MARTIN RD STE 9",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376152245",
            "telephone_number": "423-477-1101",
            "fax_number": "423-477-1102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 ROY MARTIN RD STE 9",
            "city": "GRAY",
            "state": "TN",
            "postal_code": "376152245",
            "telephone_number": "423-477-1101",
            "fax_number": "423-477-1102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMM",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-09",
        "last_updated": "2023-03-29",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT24062",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "10130",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gray, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2023; 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.