Individual provider Active NPI

Jay C Willard Jr., PT, DPT

  • Physical Therapist
  • Knoxville, TN
National Provider Identifier
1710239595
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT6913 Issued in TN
Practice address
1619 Hightop TRL
Knoxville, TN 37923-1118
Phone
(865) 584-1054
NPI assigned
Oct 4, 2012
Sex
Male
Sole proprietor
No

Organizations & group practices 9

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.

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Apple Healthcare Group PC 13 clinicians

Practice addresses (Care Compare)

4307 Ball Camp Pike
Knoxville, TN 37921-3313
Phone (865) 524-1234

Merit-based Incentive Payment System (MIPS)

Final score
85.88 of 100Reported as group
Quality
81.99
Promoting interoperability
100
Improvement activities
40
Cost
70.94

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130109000515 TN Practitioner - Physical Therapist in Private Practice 0749433399 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6913TNMDClinical Social Worker
PT6913TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Apple Healthcare Group, PC Physical Therapist CurrentSince Nov 1, 2024 Accepting new patients
Apple Healthcare Group CurrentSince Nov 1, 2024 Accepting new patients
Orthotennessee Physical Therapist Past Accepting new patients
Hovis Orthopaedic Clinic PC Past Accepting new patients
Orthotennessee, PC Past Accepting new patients
Familycare Specialists PC Past Accepting new patients
Covenant Medical Group, Inc Past Accepting new patients
Therapy Center Inc Physical Therapist Past Accepting new patients
Covenant Medical Group, Inc. Past Accepting new patients

Locations

312 Prosperity Dr
Ste 101
Knoxville, TN 37923
Phone (865) 524-1234

4307 Ball Camp Pike
Knoxville, TN 37921
Phone (865) 524-1234

Interoperability endpoints

  • FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/
  • Direct secure messaging: jay.willard.p1@direct.orthotn.nextgenshare.com

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT6913 TN Primary

Addresses

NPPES NPI Registry

Primary practice location

1619 Hightop TRL
Knoxville, TN 37923-1118

Mailing address

1619 Hightop TRL
Knoxville, TN 37923-1118

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 29, 2025.

{
    "created_epoch": "1349308800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738108800000",
    "number": "1710239595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1619 HIGHTOP TRL",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379231118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1619 HIGHTOP TRL",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379231118",
            "telephone_number": "865-584-1054"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLARD",
        "first_name": "JAY",
        "middle_name": "C",
        "name_suffix": "Jr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-04",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT6913",
            "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 Jan 29, 2025; 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.