Individual provider Active NPI

David A Self, MPT

  • Physical Therapist
  • Cleveland, TN
National Provider Identifier
1750443560
Registry record updated Nov 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5299 Issued in TN
Practice address
2700 Westside Dr NW
Suite 301
Cleveland, TN 37312-3699
Phone
(423) 479-3600
Fax
(423) 303-1234
NPI assigned
Dec 15, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 19, 2008

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 5299 TN Primary

Addresses

Primary practice location

2700 Westside Dr NW
Suite 301
Cleveland, TN 37312-3699

Mailing address

2700 Westside Dr NW
Suite 301
Cleveland, TN 37312-3699
Phone (423) 479-3600

Other identifiers 1

IdentifierTypeStateIssuer
4096931OtherTNBCBS OF TN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5299TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Pinnacle Physical Medicine & Rehab Physical Therapist PastSince Dec 31, 2003 Accepting new patients
Voytik Center for Orthopedic Care, PC Past Accepting new patients

Organizations & group practices 2

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": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227052800000",
    "number": "1750443560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2700 WESTSIDE DR NW",
            "address_2": "SUITE 301",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123699",
            "telephone_number": "423-479-3600",
            "fax_number": "423-303-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2700 WESTSIDE DR NW",
            "address_2": "SUITE 301",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373123699",
            "telephone_number": "423-479-3600",
            "fax_number": "423-303-1234"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELF",
        "first_name": "DAVID",
        "middle_name": "A",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2008-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "5299",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF TN",
            "identifier": "4096931",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2008; 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.