Pamela Diane Everett – Physical Therapy Assistant

Key facts

NPI: 1679853022
Entity type: Individual (NPI type 1)
Primary specialty: Physical Therapy Assistant 225200000X
License: 0000000602 (TN)
Practice address: 1094 Mulberry St
Loudon, TN 37774-1364
Phone: (865) 458-8900
Fax: (865) 458-8626
NPI assigned: Aug 17, 2011
Sex: Female
Sole proprietor: No

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 and National Provider Directory roles.

Little Tennessee Valley Educational Cooperative Local Education Agency (LEA) · Loudon, TN · NPI 1114256039

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
0000000602	TN	MD	Physical Therapy Assistant

Practice roles

Organization	Specialty	Status	New patients
Little Tennessee Valley Educational Cooperative		Past	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapy Assistant	225200000X	0000000602	TN	Yes

Addresses

Primary practice location

1094 Mulberry St
Loudon, TN 37774-1364

Mailing address

1094 Mulberry St
Loudon, TN 37774-1364
Phone (865) 458-8900

Other names

Pamela Diane Maney Former name

Other providers in Loudon, TN

All providers in Loudon, TN · Physical Therapy Assistant in Tennessee

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2011. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.