Organization Active NPI

Pierce Physical Therapy

  • Physical Therapist
  • Oak Ridge, TN
National Provider Identifier
1730134008
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1362 Issued in TN
Legal business name
PIERCE PHYSICAL THERAPY
Practice address
661 Emory Valley Rd
Suite a
Oak Ridge, TN 37830-7763
Phone
(865) 483-0383
Fax
(865) 483-0533
NPI assigned
May 24, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Mr. Raymond R Pierce, M.S., P.T.NPI 1881640001
Title
Clinic Director Physical Therapist
Phone
(865) 483-0383

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 1362 TN Primary

Addresses

Primary practice location

661 Emory Valley Rd
Suite a
Oak Ridge, TN 37830-7763

Mailing address

661 Emory Valley Rd
Suite a
Oak Ridge, TN 37830-7763
Phone (865) 483-0383

Other identifiers 4

IdentifierTypeStateIssuer
5564393OtherTNAETNA
3724563MedicaidTN
4023490OtherTNBLUE CROSS BLUE SHIELD
1134919OtherTNUNITED HEALTHCARE

Other names 1

  • PIERCE SPORTS THERAPY Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040417000258 TN Part B Supplier - Clinic/Group Practice 1254326481 Receives reassigned benefits from 2 practitioners
Practice locations: Oak Ridge, TN

National Provider Directory

National Provider Directory

Locations

699 Emory Valley Rd
Oak Ridge, TN 37830
Phone (865) 483-0383

661B Emory Valley Rd
Oak Ridge, TN 37830
Phone (865) 350-6312

Practitioners & affiliated clinicians

Practitioners 2

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": "1148428800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1730134008",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "661 EMORY VALLEY RD",
            "address_2": "SUITE A",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378307763",
            "telephone_number": "865-483-0383",
            "fax_number": "865-483-0533"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "661 EMORY VALLEY RD",
            "address_2": "SUITE A",
            "city": "OAK RIDGE",
            "state": "TN",
            "postal_code": "378307763",
            "telephone_number": "865-483-0383",
            "fax_number": "865-483-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PIERCE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-24",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "PIERCE",
        "authorized_official_first_name": "RAYMOND",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "CLINIC DIRECTOR PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "865-483-0383",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.S., P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "1362",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "5564393",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3724563",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "4023490",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "1134919",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PIERCE SPORTS THERAPY",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Oak Ridge, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.