Individual provider Active NPI

Laura Elizabeth Patterson, P.T.

  • Physical Therapist
  • Jackson, TN
National Provider Identifier
1780715474
Registry record updated Jul 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
0000003309 Issued in TN
Practice address
176 W University Pkwy Ste E
Jackson, TN 38305-1618
Phone
(731) 300-4950
Fax
(731) 300-4951
NPI assigned
Mar 7, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 7, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X PT3309 TN
Physical Therapist 225100000X 0000003309 TN Primary

Addresses

Primary practice location

176 W University Pkwy Ste E
Jackson, TN 38305-1618

Mailing address

176 W University Pkwy Ste C
Jackson, TN 38305-1618
Phone (731) 300-4950

Other practice location 1

176 W University Pkwy Ste E-F
Jackson, TN 38305-1618
Phone (731) 300-4950

Other practice location 2

1492 S Highland Ave
Jackson, TN 38301-3830
Phone (731) 300-4950

Other practice location 3

400 US Highway 45 W
Humboldt, TN 38343-8503
Phone (731) 784-7773

Other identifiers 2

IdentifierTypeStateIssuer
3378522MedicaidTN
Q073075MedicaidTN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130625000363 TN Practitioner - Physical Therapist in Private Practice 1850370610 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Tennessee, HSC, College of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Patterson Physical Therapy LLCGroup PAC ID 8022259878, 8 clinicians

Practice addresses (Care Compare)

176 W University Pkwy
Suite E F
Jackson, TN 38305-1618
Phone (731) 300-4950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3309TNMDRegistered Dietitian
0000003309TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Patterson Physical Therapy LLC Multi-Specialty CurrentSince May 1, 2013 Accepting new patients

Locations

1492 S Highland Ave
Jackson, TN 38301
Phone (731) 300-4950

176 W University Pkwy
Ste Ef
Jackson, TN 38305
Phone (731) 300-4950

176 W University Pkwy
Ste C
Jackson, TN 38305
Phone (731) 660-6915

15 Stonebridge Blvd
Jackson, TN 38305
Phone (731) 265-6946

176 W University Pkwy
Ste E
Jackson, TN 38305
Phone (731) 300-3543

400 US Highway 45 W
Three Way, TN 38343
Phone (731) 784-7771

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1173225600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1657152000000",
    "number": "1780715474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "176 W UNIVERSITY PKWY STE C",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051618",
            "telephone_number": "731-300-4950",
            "fax_number": "731-300-4951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 W UNIVERSITY PKWY STE E",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383051618",
            "telephone_number": "731-300-4950",
            "fax_number": "731-300-4951"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "176 W University Pkwy Ste E-F",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383051618",
            "country_code": "US",
            "telephone_number": "731-300-4950",
            "fax_number": "731-300-4951",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1492 S Highland Ave",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "TN",
            "postal_code": "383013830",
            "country_code": "US",
            "telephone_number": "731-300-4950",
            "fax_number": "731-300-4951",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "400 US Highway 45 W",
            "address_purpose": "LOCATION",
            "city": "Humboldt",
            "state": "TN",
            "postal_code": "383438503",
            "country_code": "US",
            "telephone_number": "731-784-7773",
            "fax_number": "731-300-4951",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATTERSON",
        "first_name": "LAURA",
        "middle_name": "ELIZABETH",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-07",
        "last_updated": "2022-07-07",
        "certification_date": "2022-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "TN",
            "license": "PT3309",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "0000003309",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3378522",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q073075",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Jackson, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.