Individual provider Active NPI

Shane Hargis

  • Physical Therapist
  • Knoxville, TN
National Provider Identifier
1689405706
Registry record updated Aug 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
15571 Issued in TN
Practice address
104 Jack Dance St
Knoxville, TN 37919-5576
Phone
(865) 691-8381
NPI assigned
Aug 10, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2024

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 15571 TN Primary

Addresses

Primary practice location

104 Jack Dance St
Knoxville, TN 37919-5576

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 933-1260

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241016002803 TN Practitioner - Physical Therapist in Private Practice 0941732804 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians

Practice addresses (Care Compare)

104 Jack Dance St
Knoxville, TN 37919-5576
Phone (865) 691-8381

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Results-Ast JV, LLC Physical Therapist CurrentSince Aug 12, 2024 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Aug 12, 2024 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Aug 12, 2024 Accepting new patients

Locations

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

3493 Veterans Dr N
Ste D
Huntingdon, TN 38344
Phone (731) 209-4444

104 Jack Dance St
Knoxville, TN 37919
Phone (865) 391-8381

5220 Park Ave
Ste 201
Memphis, TN 38119
Phone (901) 683-9630

2030 Cowan Hwy
Ste 1
Winchester, TN 37398
Phone (931) 968-1080

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 and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1723248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723248000000",
    "number": "1689405706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-933-1260"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 JACK DANCE ST",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379195576",
            "telephone_number": "865-691-8381"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARGIS",
        "first_name": "SHANE",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-10",
        "last_updated": "2024-08-10",
        "certification_date": "2024-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "15571",
            "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 Aug 10, 2024; 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.