Marie Ellen Abdu, COTA/L

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

0000013128 Issued in TN

Practice address

601 W Broadway St
Lenoir City, TN 37771-2702

Phone

(865) 816-3611

Fax

(865) 816-6047

NPI assigned

Sep 17, 2006

Last updated

Oct 5, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Advanced Rehabilitation & Pain Managemen

  • Physical Therapist
  • Knoxville, TN
  • NPI 1699105049
  NPD (past)
• Advanced Rehabilitation & Pain Management LLC

  dba Advanced Physiotherapy Clinic

  • Physical Therapy Clinic/Center
  • Lenoir City, TN
  • NPI 1376946491
  NPD (past)

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

{
    "created_epoch": "1158451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601856000000",
    "number": "1689771230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "511 W BROADWAY ST",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377712806",
            "telephone_number": "865-661-2785",
            "fax_number": "865-816-6047"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W BROADWAY ST",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377712702",
            "telephone_number": "865-816-3611",
            "fax_number": "865-816-6047"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABDU",
        "first_name": "MARIE",
        "middle_name": "ELLEN",
        "credential": "COTA/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-17",
        "last_updated": "2020-10-05",
        "certification_date": "2020-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "TN",
            "license": "OTA0000000587",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "TN",
            "license": "0000013128",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "marie@advptclinic.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "601 W Broadway St",
            "city": "Lenoir City",
            "state": "TN",
            "country_code": "US",
            "postal_code": "377712702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• ABA Next Steps
• Wahid John Abadier, MD
• Bassem A Abazid, M.D.
• Ahmed Kassem Selim Abdallah, M.D
• Maged Yousif Abdu, P.T.
• Walter Adams
• Scott L Adkisson
• Adult Community Training Inc.
• Advanced Foot Care, LLP
• Advanced Medical Group, P.C.

• Massage Therapist in Lenoir City, TN
• Providers in Lenoir City, TN by specialty
• Massage Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2020; 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.