Active NPI
John Thompson
- Physical Therapy Assistant
- Cordova, TN
National Provider Identifier
1780147264
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA0000005986
- Practice address
- 36 Bazeberry Rd
Cordova, TN 38018-7754 - Phone
- (901) 758-0036
- NPI assigned
- Apr 10, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA0000005986 | TN | Primary |
Addresses
Primary practice location
36 Bazeberry Rd
Cordova, TN 38018-7754
Mailing address
2745 Lynchburg St
Memphis, TN 38134-4321
Phone (901) 691-7371
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 088118740 | Other | TN | DRIVING LICENSE |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA0000005986 | TN | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1554854400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1554854400000",
"number": "1780147264",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2745 LYNCHBURG ST",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381344321",
"telephone_number": "901-691-7371"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "36 BAZEBERRY RD",
"city": "CORDOVA",
"state": "TN",
"postal_code": "380187754",
"telephone_number": "901-758-0036"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMPSON",
"first_name": "JOHN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-04-10",
"last_updated": "2019-04-10",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TN",
"license": "PTA0000005986",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DRIVING LICENSE",
"identifier": "088118740",
"state": "TN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Cordova, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 10, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.