Active NPI
MCM Rehabilitation, LLC.
- Durable Medical Equipment & Medical Supplies
- Chattanooga, TN
National Provider Identifier
1780199422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Durable Medical Equipment & Medical Supplies
- Legal business name
- MCM REHABILITATION, LLC.
- Practice address
- 1630 McCallie Ave
Chattanooga, TN 37404-3021 - Phone
- (423) 698-5590
- Fax
- (423) 698-5519
- NPI assigned
- Dec 4, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Wade A Meyer
- Title
- VP Chief Compliance Officer
- Phone
- (630) 296-2222
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Durable Medical Equipment & Medical Supplies | 332B00000X | Primary |
Addresses
Primary practice location
1630 McCallie Ave
Chattanooga, TN 37404-3021
Mailing address
790 Remington Blvd
Bolingbrook, IL 60440-4909
Other names 1
- ATI Physical Therapy
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in TN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20180619003596 | TN | DME Supplier - Independently-Practicing Physical Therapist | 5294798336 | Practice locations: Chattanooga, TN |
Other NPIs with the same Medicare PAC ID 2
NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).
-
- Durable Medical Equipment & Medical Supplies
- Chattanooga, TN
- NPI 1538632005
5294798336
National Provider Directory
National Provider Directory- Tax ID family
- Ati Physical Therapy
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Durable Medical Equipment & Medical Supplies
- Chattanooga, TN
- NPI 1538632005
Member of 1
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1512345600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1724025600000",
"number": "1780199422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "790 REMINGTON BLVD",
"city": "BOLINGBROOK",
"state": "IL",
"postal_code": "604404909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1630 MCCALLIE AVE",
"city": "CHATTANOOGA",
"state": "TN",
"postal_code": "374043021",
"telephone_number": "423-698-5590",
"fax_number": "423-698-5519"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "MCM REHABILITATION, LLC.",
"organizational_subpart": "NO",
"enumeration_date": "2017-12-04",
"last_updated": "2024-08-19",
"certification_date": "2024-08-19",
"status": "A",
"authorized_official_last_name": "MEYER",
"authorized_official_first_name": "WADE",
"authorized_official_middle_name": "A",
"authorized_official_title_or_position": "VP CHIEF COMPLIANCE OFFICER",
"authorized_official_telephone_number": "630-296-2222"
},
"taxonomies": [
{
"code": "332B00000X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "ATI Physical Therapy",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Chattanooga, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.