Tatyana A Bolshakova-McGehee, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

PTA0000004387 Issued in TN

Practice address

8516 Timber Run CV
Cordova, TN 38018-7318

Phone

(901) 734-5270

NPI assigned

Sep 20, 2023

Last updated

Sep 20, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1770361677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8516 TIMBER RUN CV",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380187318",
            "telephone_number": "901-734-5270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8516 TIMBER RUN CV",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380187318",
            "telephone_number": "901-734-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOLSHAKOVA-MCGEHEE",
        "first_name": "TATYANA",
        "middle_name": "A",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-20",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "PTA0000004387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Assistant in Cordova, TN
• Providers in Cordova, TN by specialty
• Physical Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.