Individual provider Active NPI

Amy Suzanne Villacci, PT, DPT

  • Physical Therapist
  • Cleveland, TN
National Provider Identifier
1619258431
Registry record updated Sep 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT8796 Issued in TN
Practice address
102 Dunhill PL NW
Ste. B
Cleveland, TN 37311-3890
Phone
(423) 559-0444
NPI assigned
Sep 7, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT8796 TN Primary

Addresses

Primary practice location

102 Dunhill PL NW
Ste. B
Cleveland, TN 37311-3890

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

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
PT8796TNMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1315353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316649600000",
    "number": "1619258431",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 DUNHILL PL NW",
            "address_2": "STE. B",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373113890",
            "telephone_number": "423-559-0444"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VILLACCI",
        "first_name": "AMY",
        "middle_name": "SUZANNE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-07",
        "last_updated": "2011-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT8796",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2011; 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.