Individual provider Active NPI

Timothy Logan Irwin, PT, DPT

  • Physical Therapist
  • Chattanooga, TN
National Provider Identifier
1700458643
Registry record updated Nov 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
13565 Issued in TN
Practice address
7443 Commons Blvd Ste 112
Chattanooga, TN 37421-2895
Phone
(423) 254-5461
Fax
(800) 385-7439
NPI assigned
Jul 12, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 17, 2023

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 13565 TN Primary

Addresses

Primary practice location

7443 Commons Blvd Ste 112
Chattanooga, TN 37421-2895

Mailing address

625 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-2395
Phone (616) 356-5000

Other practice location 1

403 Gallatin Farmers Ave
Belgrade, MT 59714-9142
Phone (406) 388-7229

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20231213002064 TN Practitioner - Physical Therapist in Private Practice 3375933633 Reassigns benefits to 2 organizations
I20241230002545 GA Practitioner - Physical Therapist in Private Practice 3375933633 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Excel Rehabilitation and Sports 53 clinicians
Lookout Mountain Physical Therapy LLC 4 clinicians

Practice addresses (Care Compare)

3460 Battlefield Pkwy
Fort Oglethorpe, GA 30742-4007
Phone (706) 719-2253

7443 Commons Blvd
Suite a
Chattanooga, TN 37421-2896
Phone (423) 254-5461

820 Scenic Hwy
Suite B
Lookout Mountain, TN 37350-1418
Phone (731) 313-0057

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13565TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Rehabilitation and Sports Physical Therapist CurrentSince Jan 8, 2024 Accepting new patients
Excel Rehabilitation and Sports Physical Therapist CurrentSince Jan 8, 2024 Accepting new patients
Lone Peak Physical Therapy at Belgrade PastSince May 1, 2022 Accepting new patients
Yellowstone Physical Therapy Inc. Physical Therapist PastSince Jan 27, 2024 Accepting new patients

Locations

3460 Battlefield Pkwy
Ft Oglethorpe, GA 30742
Phone (706) 719-2253

625 Kenmoor Ave SE
Ste 100
Grand Rapids, MI 49546

2158 Northgate Park Ln
Ste 200
Chattanooga, TN 37415
Phone (423) 254-5461

313 Manufacturers Rd
Ste C215
Chattanooga, TN 37405
Phone (423) 254-5461

7443 Commons Blvd
Ste 112
Chattanooga, TN 37421
Phone (423) 254-5461

7443 Commons Blvd
Ste A
Chattanooga, TN 37421
Phone (423) 254-5461

1700 Broad St
Ste 120
Chattanooga, TN 37408
Phone (423) 254-5461

862 Callen Ln NW
Ste 100
Cleveland, TN 37312
Phone (423) 254-5461

Organizations & group practices 8

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": "1626048000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700179200000",
    "number": "1700458643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "625 KENMOOR AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495462395",
            "telephone_number": "616-356-5000",
            "fax_number": "616-356-5001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7443 COMMONS BLVD STE 112",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212895",
            "telephone_number": "423-254-5461",
            "fax_number": "800-385-7439"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "403 Gallatin Farmers Ave",
            "address_purpose": "LOCATION",
            "city": "Belgrade",
            "state": "MT",
            "postal_code": "597149142",
            "country_code": "US",
            "telephone_number": "406-388-7229",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "IRWIN",
        "first_name": "TIMOTHY",
        "middle_name": "LOGAN",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-12",
        "last_updated": "2023-11-17",
        "certification_date": "2023-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "13565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Chattanooga, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2023; 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.