Russell Wayne Carr, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12261 Issued in TN

Practice address

1704 E Stone Dr Ste 120
Kingsport, TN 37660-4679

Phone

(423) 765-0985

NPI assigned

Aug 13, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

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": "1502582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1583712000000",
    "number": "1639694490",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214915",
            "telephone_number": "423-238-8930",
            "fax_number": "423-254-5217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1704 E STONE DR STE 120",
            "city": "KINGSPORT",
            "state": "TN",
            "postal_code": "376604679",
            "telephone_number": "423-765-0985"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 Town Blvd NE Ste S550",
            "address_purpose": "LOCATION",
            "city": "Brookhaven",
            "state": "GA",
            "postal_code": "303197216",
            "country_code": "US",
            "telephone_number": "404-869-1912",
            "fax_number": "404-869-6515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "705 Town Blvd NE Ste S550",
            "address_purpose": "LOCATION",
            "city": "Brookhaven",
            "state": "GA",
            "postal_code": "303197216",
            "country_code": "US",
            "telephone_number": "404-869-1912",
            "fax_number": "404-869-6515",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2913 Boones Creek Rd Ste 1",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "37615",
            "country_code": "US",
            "telephone_number": "423-232-0688",
            "fax_number": "423-232-0687",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CARR",
        "first_name": "RUSSELL",
        "middle_name": "WAYNE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-13",
        "last_updated": "2020-03-09",
        "certification_date": "2020-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT013054",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "12261",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Terry K. Carle, P.A.
• Torrey Jon Carlson, O.D.
• Foy Lynn Carmichael, PT
• Kyle T Caron, DO
• Nathan McLain Carpenter
• Brandy Nicole Carraway, LCSW
• Marcy Carrier
• Sarah Nicole Carrier, APRN-BC
• Ashley C. Carroll, NP
• Daniel D Carroll, MD

• Physical Therapist in Kingsport, TN
• Providers in Kingsport, 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 9, 2020; 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.