Organization Active NPI

Living Well Physical Therapy

  • Physical Therapy Clinic/Center
  • Johnson City, TN
National Provider Identifier
1689418113
Registry record updated Jun 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
LIVING WELL PHYSICAL THERAPY
Practice address
3009 Greenline Rd
Johnson City, TN 37604-4140
Phone
(315) 751-3082
NPI assigned
Jun 20, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Christa Smith, PT DPT, OCS, FAAOMPTNPI 1578195608
Title
Physical Therapist
Phone
(315) 751-3082

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

3009 Greenline Rd
Johnson City, TN 37604-4140

Mailing address

2086 Meadow Creek LN
Jonesborough, TN 37659-0600
Phone (315) 751-3082

National Provider Directory

National Provider Directory

Locations

3009 Greenline Rd
Johnson City, TN 37604
Phone (315) 751-3082

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1718841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1689418113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2086 MEADOW CREEK LN",
            "city": "JONESBOROUGH",
            "state": "TN",
            "postal_code": "376590600",
            "telephone_number": "315-751-3082"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3009 GREENLINE RD",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376044140",
            "telephone_number": "315-751-3082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVING WELL PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "CHRISTA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "315-751-3082",
        "authorized_official_credential": "PT DPT, OCS, FAAOMPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.