Individual provider Active NPI

Kerrianna Clark Neilson, DPT

  • Physical Therapist
  • Lenoir City, TN
National Provider Identifier
1801234976
Registry record updated Jun 11, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9688 Issued in TN
Practice address
501 Adessa Pkwy
Ste A140
Lenoir City, TN 37771-6725
Phone
(865) 988-7610
Fax
(865) 988-6636
NPI assigned
Jun 11, 2013
Last updated
Jun 11, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2013

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 9688 TN Primary

Addresses

Primary practice location

501 Adessa Pkwy
Ste A140
Lenoir City, TN 37771-6725

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
9688TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Agilitas USA Inc CurrentSince Jan 9, 2024 Accepting new patients
Independent Physical Therapy, LLC Physical Therapist CurrentSince Jun 17, 2013 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Jan 9, 2024 Accepting new patients
Agilitas USA Inc Physical Therapist Current Accepting new patients
Independent Physical Therapy LLC Physical Therapist Past Accepting new patients
Benchmark Healthcare Services LLC Past Accepting new patients

Locations

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

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (866) 518-0283

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

7688 Oak Ridge Hwy
Knoxville, TN 37931
Phone (865) 313-2865

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

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

8823 Production Ln
Ooltewah, TN 37363
Phone (423) 238-8930

Organizations & group practices 6

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

NPI Registry JSON

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

{
    "created_epoch": "1370908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1370908800000",
    "number": "1801234976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501 ADESSA PKWY",
            "address_2": "STE A140",
            "city": "LENOIR CITY",
            "state": "TN",
            "postal_code": "377716725",
            "telephone_number": "865-988-7610",
            "fax_number": "865-988-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEILSON",
        "first_name": "KERRIANNA",
        "middle_name": "CLARK",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-11",
        "last_updated": "2013-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "9688",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lenoir City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2013; 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.