Individual provider Active NPI

Rainelda Lariosa, PT

  • Physical Therapist
  • Union City, TN
National Provider Identifier
1801297908
Registry record updated Sep 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT0000004747 Issued in TN
Practice address
126 E Main St
Suite C
Union City, TN 38261-3349
Phone
(731) 599-9896
Fax
(866) 611-9554
NPI assigned
Sep 8, 2014
Last updated
Sep 8, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 8, 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 PT0000004747 TN Primary

Addresses

Primary practice location

126 E Main St
Suite C
Union City, TN 38261-3349

Mailing address

126 E Main St
Suite C
Union City, TN 38261-3349
Phone (731) 599-9896

Other identifiers 1

IdentifierTypeStateIssuer
PT0000004747OtherTNPHYSICAL THERAPIST LICENSE TENN HEALTH RELATED BOARDS

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250321002539 TN Practitioner - Physical Therapist in Private Practice 8426570169 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aegis Group Practice LLCGroup PAC ID 5193036432, 399 clinicians

Practice addresses (Care Compare)

1535 Appling Care LN
Cordova, TN 38016-4994
Phone (901) 883-0262

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT0000004747TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Physical Therapist Current Accepting new patients
Aegis Group Practice LLC Physical Therapist CurrentSince Dec 19, 2024 Accepting new patients
Aegis Group Practice LLC Physical Therapist CurrentSince Dec 19, 2024 Accepting new patients
La Speech Therapy PC Past Accepting new patients

Locations

4933 Old Greenwood Rd
Fort Smith, AR 72903

1535 Appling Care Ln
Cordova, TN 38016
Phone (901) 377-7500

Organizations & group practices 4

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": "1410134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410134400000",
    "number": "1801297908",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "126 E MAIN ST",
            "address_2": "SUITE C",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382613349",
            "telephone_number": "731-599-9896",
            "fax_number": "866-611-9554"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "126 E MAIN ST",
            "address_2": "SUITE C",
            "city": "UNION CITY",
            "state": "TN",
            "postal_code": "382613349",
            "telephone_number": "731-599-9896",
            "fax_number": "866-611-9554"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LARIOSA",
        "first_name": "RAINELDA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-08",
        "last_updated": "2014-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT0000004747",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST LICENSE TENN HEALTH RELATED BOARDS",
            "identifier": "PT0000004747",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Union City, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2014; 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.