Individual provider Active NPI

Andrew Oneal Mansell, DPT

  • Physical Therapist
  • Chattanooga, TN
National Provider Identifier
1679066385
Registry record updated Jun 8, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
11712 Issued in TN
Practice address
6172 Airways Blvd Ste 122
Chattanooga, TN 37421-2915
Phone
(423) 622-1551
NPI assigned
Jun 8, 2018
Last updated
Jun 8, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 8, 2018

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 11712 TN Primary

Addresses

Primary practice location

6172 Airways Blvd Ste 122
Chattanooga, TN 37421-2915

Mailing address

PO Box 8114
Chattanooga, TN 37414-0114

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221107000182 GA Practitioner - Physical Therapist in Private Practice 7719354695 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11712TNMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
North Georgia Pediatric Therapies, LLC Physical Therapist CurrentSince Oct 11, 2023 Accepting new patients
North Georgia Pediatric Therapies, LLC Physical Therapist CurrentSince Oct 11, 2023 Accepting new patients

Locations

1821 Battlefield Pkwy
Fort Oglethorpe, GA 30742
Phone (706) 861-7471

Organizations & group practices 2

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": "1528416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528416000000",
    "number": "1679066385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 8114",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374140114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6172 AIRWAYS BLVD STE 122",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212915",
            "telephone_number": "423-622-1551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANSELL",
        "first_name": "ANDREW",
        "middle_name": "ONEAL",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-08",
        "last_updated": "2018-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "11712",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.