Melissa Wilburn, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

3082 Issued in TN

Practice address

110 Skyline Dr Ste B
Maynardville, TN 37807-3063

Phone

(865) 992-6933

Fax

(865) 992-6870

NPI assigned

Jan 13, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Tennessee Therapeutics, Inc.

  • Physical Therapy Clinic/Center
  • Maynardville, TN
  • NPI 1659365757
  NPD

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

{
    "created_epoch": "1642032000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642032000000",
    "number": "1831840677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 COSBY CIR",
            "city": "TAZEWELL",
            "state": "TN",
            "postal_code": "378793917",
            "telephone_number": "606-269-8661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 SKYLINE DR STE B",
            "city": "MAYNARDVILLE",
            "state": "TN",
            "postal_code": "378073063",
            "telephone_number": "865-992-6933",
            "fax_number": "865-992-6870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBURN",
        "first_name": "MELISSA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-13",
        "last_updated": "2022-01-13",
        "certification_date": "2022-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "TN",
            "license": "3082",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vivek Kalpathi Venkatesh, MD
• Briana Michelle Viens, APN
• Walgreen Co
• Mary Jane Walker, FNP
• Haley L Waller, RN
• Hannah Wilford, DPT
• Betsy Williams, RN
• Wiser Way Counseling
• Penny Ann Wood, B.A.
• Chloe Briann Wright, RN

• Physical Therapy Assistant in Maynardville, TN
• Providers in Maynardville, TN by specialty
• Physical Therapy Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2022; 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.