Individual provider Active NPI

Russell Whitten, DPT

  • Physical Therapist
  • Bartlett, TN
National Provider Identifier
1790101996
Registry record updated Mar 12, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9622 Issued in TN
Practice address
8070 Highway 64 Suite 104
Bartlett, TN 38133
Phone
(901) 266-3838
Fax
(901) 266-3820
NPI assigned
Mar 12, 2014
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9622 TN Primary

Addresses

Primary practice location

8070 Highway 64 Suite 104
Bartlett, TN 38133

Mailing address

8070 Highway 64 Suite 104
Bartlett, TN 38133
Phone (901) 266-3838

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, MS, SC3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20171116001433 TN Practitioner - Physical Therapist in Private Practice 5890051379 Reassigns benefits to 3 organizations
I20180124000615 MS Practitioner - Physical Therapist in Private Practice 5890051379 Reassigns benefits to 2 organizations
I20180529000028 SC Practitioner - Physical Therapist in Private Practice 5890051379 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9622TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dynamix Physical Therapy LLC CurrentSince Feb 12, 2024 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince May 6, 2024 Accepting new patients
Independent Physical Therapy, LLC Physical Therapist CurrentSince Aug 14, 2017 Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist CurrentSince Jan 15, 2018 Accepting new patients
Benchmark Healthcare Services, LLC Physical Therapist CurrentSince Apr 23, 2018 Accepting new patients
Dpti Elite Physical Therapy LLC Physical Therapist CurrentSince Jan 15, 2018 Accepting new patients
Benchmark Healthcare Services, LLC Physical Therapist Current Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince May 6, 2024 Accepting new patients
Benchmark Health Services Physical Therapist CurrentSince Apr 23, 2018 Accepting new patients
Dpti Elite Physical Therapy LLC Physical Therapist CurrentSince Jan 15, 2018 Accepting new patients
Drayer Physical Therapy Mississippi LLC Physical Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

715 Highway 45
Baldwyn, MS 38824
Phone (662) 365-5610

2503 Virginia Ln
Corinth, MS 38834
Phone (662) 977-7180

117 Bo Bo Dr
Crystal Springs, MS 39059
Phone (601) 892-6330

2319 Highway 145
Saltillo, MS 38866
Phone (662) 869-9980

1017 Fording Island Rd
#F101
Bluffton, SC 29910
Phone (843) 815-2563

1000 Tanner Ford Blvd
Ste 370
Hanahan, SC 29410
Phone (843) 718-1058

26448 Main St
Ardmore, TN 38449
Phone (931) 427-4050

5226 Airline Rd
Ste 131
Arlington, TN 38002
Phone (901) 441-7997

5 N Lafayette Ave
Brownsville, TN 38012
Phone (731) 613-2214

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

1202 N Charles G Seivers Blvd
Ste A
Clinton, TN 37716
Phone (865) 457-0192

3493 Veterans Dr N
Ste D
Huntingdon, TN 38344
Phone (731) 209-4444

820 Scenic Hwy
Ste B
Lookout Mtn, TN 37350
Phone (423) 825-1393

104 Oxford St
Martin, TN 38237
Phone (731) 587-3422

5220 Park Ave
Ste 201
Memphis, TN 38119
Phone (901) 683-9630

2060 Rhino Xing
Milan, TN 38358
Phone (731) 613-2214

8823 Production Ln
Ooltewah, TN 37363
Phone (423) 238-8923

Organizations & group practices 11

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": "1394582400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394582400000",
    "number": "1790101996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8070 HIGHWAY 64 SUITE 104",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "38133",
            "telephone_number": "901-266-3838",
            "fax_number": "901-266-3820"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8070 HIGHWAY 64 SUITE 104",
            "city": "BARTLETT",
            "state": "TN",
            "postal_code": "38133",
            "telephone_number": "901-266-3838",
            "fax_number": "901-266-3820"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WHITTEN",
        "first_name": "RUSSELL",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-03-12",
        "last_updated": "2014-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "9622",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bartlett, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2014; 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.

Verify at the official NPI Registry.