Individual provider Active NPI

Andrew Black

  • Physical Therapist
  • Fayetteville, TN
National Provider Identifier
1669324414
Registry record updated Feb 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
16924 Issued in TN
Practice address
2649 Huntsville Hwy
Fayetteville, TN 37334-6778
Phone
(931) 557-5030
NPI assigned
Feb 13, 2026
Last updated
Feb 13, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2026

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 16924 TN Primary

Addresses

Primary practice location

2649 Huntsville Hwy
Fayetteville, TN 37334-6778

Mailing address

2649 Huntsville Hwy
Fayetteville, TN 37334-6778

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20260224001800 TN Practitioner - Physical Therapist in Private Practice 4385125749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Therafit, LLCGroup PAC ID 1557390671, 11 clinicians

Practice addresses (Care Compare)

2649 Huntsville Hwy
Fayetteville, TN 37334-6778
Phone (356) 829-9544

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
16924TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therafit, LLC Physical Therapist CurrentSince Feb 16, 2026 Accepting new patients

Locations

12819 Highway 231 431 N
#G
Hazel Green, AL 35750
Phone (256) 829-9544

2649 Huntsville Hwy
Fayetteville, TN 37334
Phone (356) 829-9544

Organizations & group practices 1

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": "1770940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1770940800000",
    "number": "1669324414",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2649 HUNTSVILLE HWY",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "373346778"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2649 HUNTSVILLE HWY",
            "city": "FAYETTEVILLE",
            "state": "TN",
            "postal_code": "373346778",
            "telephone_number": "931-557-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "ANDREW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-02-13",
        "last_updated": "2026-02-13",
        "certification_date": "2026-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "16924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2026; 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.