Russell Atkins, PT
Individual provider Active NPI Physical Therapist · Ooltewah, TN
NPI 1760699110 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1760699110
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 6211 (TN)
- Practice address
- 5704 Main St
Ooltewah, TN 37363-8713 - Phone
- (423) 238-1301
- NPI assigned
- May 16, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Loma Linda University School of Medicine, 1989
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
5704 Main St
Ooltewah, TN 37363-8095
Phone (423) 238-1301
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20040820000743 | TN | Practitioner - Physical Therapist in Private Practice | 1557335122 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6211 | TN | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 101 Physical Therapy, Inc | Current |
Accepting new patients |
Locations
5704 Main St
Ooltewah, TN 37363
Phone (423) 238-1301
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 6211 | TN | Yes |
Addresses
Primary practice location
5704 Main St
Ooltewah, TN 37363-8713
Mailing address
5704 Main St
Ooltewah, TN 37363-8713
Other providers in Ooltewah, TN
- Apex Dermatology PLLC
- Art of Dentistry, PLLC
- Aspire Orthodontics, PC
- Christopher Lee Atkins
- Katie Atkins
- Atlanta South Physical Therapy, Inc.
- Eric Todd Badillo
- Troy Dale Bage
- Brittany Bailey
- Erica Louise Bailey
All providers in Ooltewah, TN · Physical Therapist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.