Active NPI
Saurabh Mehta
- Physical Therapist
- Johnson City, TN
National Provider Identifier
1760055313
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 14602
- Practice address
- 325 N State of Franklin Rd FL 2
Johnson City, TN 37604-6092 - Phone
- (423) 439-7280
- NPI assigned
- Jul 21, 2021
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 3240 | WV | |
| Physical Therapist | 225100000X | 14602 | TN | Primary |
Addresses
Primary practice location
325 N State of Franklin Rd FL 2
Johnson City, TN 37604-6092
Mailing address
PO Box 699
Mountain Home, TN 37684-0699
Other practice location 1
4 Sheridan Sq Ste 200
Kingsport, TN 37660-7435
Phone (304) 633-1656
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| Q084951 | Medicaid | 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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1626825600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1705968000000",
"number": "1760055313",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 699",
"city": "MOUNTAIN HOME",
"state": "TN",
"postal_code": "376840699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "325 N STATE OF FRANKLIN RD FL 2",
"city": "JOHNSON CITY",
"state": "TN",
"postal_code": "376046092",
"telephone_number": "423-439-7280"
}
],
"practiceLocations": [
{
"address_1": "4 Sheridan Sq Ste 200",
"address_purpose": "LOCATION",
"city": "Kingsport",
"state": "TN",
"postal_code": "376607435",
"country_code": "US",
"telephone_number": "304-633-1656",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MEHTA",
"first_name": "SAURABH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-07-21",
"last_updated": "2024-01-23",
"certification_date": "2022-09-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WV",
"license": "3240",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "TN",
"license": "14602",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "Q084951",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Johnson City, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.