Individual provider Active NPI

Kaitlyn Coddington

  • Physical Therapist
  • Knoxville, TN
National Provider Identifier
1659917268
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12687 Issued in TN
Practice address
4635 Greenway Dr Unit B
Knoxville, TN 37918-2118
Phone
(865) 546-0801
NPI assigned
Nov 19, 2019
Last updated
Apr 22, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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 12687 TN Primary

Addresses

Primary practice location

4635 Greenway Dr Unit B
Knoxville, TN 37918-2118

Mailing address

6397 Lee Hwy Ste 300
Chattanooga, TN 37421-4915
Phone (423) 238-8930

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191226002015 TN Practitioner - Physical Therapist in Private Practice 5496189532 Reassigns benefits to 1 organization
I20210519002638 GA Practitioner - Physical Therapist in Private Practice 5496189532 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3450 Cobb Pkwy NW
Suite 210
Acworth, GA 30101-8352
Phone (770) 974-1978

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12687TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy, LLC Physical Therapist CurrentSince Nov 18, 2019 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Apr 26, 2021 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Apr 26, 2021 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

3450 Cobb Pkwy NW
Ste 210
Acworth, GA 30101
Phone (770) 974-1978

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

1202 N Charles G Seivers Blvd
Ste A
Clinton, TN 37716
Phone (865) 457-0192

10665 Hardin Valley Rd
Knoxville, TN 37932
Phone (865) 690-2690

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": "1574121600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619049600000",
    "number": "1659917268",
    "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": "4635 GREENWAY DR UNIT B",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379182118",
            "telephone_number": "865-546-0801"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CODDINGTON",
        "first_name": "KAITLYN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-19",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "12687",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; 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.