Individual provider Active NPI

Jamie Lenn Roberts, PT

  • Physical Therapist
  • Knoxville, TN
National Provider Identifier
1831264381
Registry record updated Jun 24, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6900 Issued in TN
Practice address
8904 Cross Park Dr
Knoxville, TN 37923-4703
Phone
(865) 690-2671
Fax
(865) 690-6445
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2010

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 32955 CA
Physical Therapist 225100000X 9780 NC
Physical Therapist 225100000X 6900 TN Primary

Addresses

Primary practice location

8904 Cross Park Dr
Knoxville, TN 37923-4703

Mailing address

PO Box 32709
Knoxville, TN 37930-2709
Phone (865) 558-6484

Other identifiers 3

IdentifierTypeStateIssuer
4158705OtherTNBCBS
CH4394OtherTNMEDICARE-RAILROAD GROUP ID
3650014MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070813000095 TN Practitioner - Physical Therapist in Private Practice 0143311662 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Results-Ast JV LLCGroup PAC ID 4486066396, 390 clinicians

Practice addresses (Care Compare)

3556 Tom Austin Hwy
Suite 2
Springfield, TN 37172-3960
Phone (615) 492-4595

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9780NCMDPhysical Therapist
6900TNMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Results-Ast JV, LLC Physical Therapist CurrentSince Aug 22, 2022 Accepting new patients
Therapy Center Inc Physical Therapist Past Accepting new patients

Locations

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

3556 Tom Austin Hwy
Ste 2
Springfield, TN 37172
Phone (615) 492-4595

2030 Cowan Hwy
Ste 1
Winchester, TN 37398
Phone (931) 968-1080

Organizations & group practices 2

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1277337600000",
    "number": "1831264381",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 32709",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379302709",
            "telephone_number": "865-558-6484",
            "fax_number": "865-584-4037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8904 CROSS PARK DR",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379234703",
            "telephone_number": "865-690-2671",
            "fax_number": "865-690-6445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "JAMIE",
        "middle_name": "LENN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2010-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "32955",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "9780",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "6900",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "4158705",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE-RAILROAD GROUP ID",
            "identifier": "CH4394",
            "state": "TN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3650014",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Knoxville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2010; 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.