Noel Manliclic, RPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

3171 Issued in TN

Practice address

135 Generation Dr
Newport, TN 37821-8018

Phone

(423) 623-0929

NPI assigned

Apr 10, 2021

Last updated

Apr 10, 2021By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1618012800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618012800000",
    "number": "1699355081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5319 BRAZELTON RD",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379183414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 GENERATION DR",
            "city": "NEWPORT",
            "state": "TN",
            "postal_code": "378218018",
            "telephone_number": "423-623-0929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANLICLIC",
        "first_name": "NOEL",
        "name_prefix": "Mr.",
        "credential": "RPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-10",
        "last_updated": "2021-04-10",
        "certification_date": "2021-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "3171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Knoxville",
            "affiliation": "N",
            "address_1": "135 Generation Dr",
            "city": "Newport",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378218018",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Knoxville",
            "affiliation": "N",
            "endpointDescription": "-",
            "address_1": "135 Generation Dr",
            "city": "Newport",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378218018",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapist in Newport, TN
• Providers in Newport, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2021; 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.