Individual provider Active NPI

Dustin Hall, PT

  • Physical Therapist
  • Knoxville, TN
National Provider Identifier
1861014748
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT8036 Issued in TN
Practice address
9411 S Northshore Dr Ste 101
Knoxville, TN 37922-8820
Phone
(865) 766-2796
NPI assigned
May 13, 2020
Last updated
Feb 8, 2021By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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 PT8036 TN Primary

Addresses

Primary practice location

9411 S Northshore Dr Ste 101
Knoxville, TN 37922-8820

Mailing address

202 Sherwood Dr
Maryville, TN 37801-4621
Phone (865) 724-4542

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200811002705 TN Practitioner - Physical Therapist in Private Practice 3779909593 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Medical College of Georgia School of Medicine, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

4108 Asheville Hwy
Knoxville, TN 37914-3505
Phone (865) 724-4542

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT8036TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Plus CurrentSince Jun 19, 2020 Accepting new patients
Therapy Plus LLC CurrentSince Jun 19, 2020 Accepting new patients
Cryostretch LLC CurrentSince Jun 28, 2020 Accepting new patients

Locations

4108 Asheville Hwy
Knoxville, TN 37914
Phone (865) 522-3737

9411 S Northshore Dr
Ste 101
Knoxville, TN 37922
Phone (865) 724-4542

Organizations & group practices 3

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": "1589328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612742400000",
    "number": "1861014748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 SHERWOOD DR",
            "city": "MARYVILLE",
            "state": "TN",
            "postal_code": "378014621",
            "telephone_number": "865-724-4542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9411 S NORTHSHORE DR STE 101",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379228820",
            "telephone_number": "865-766-2796"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "DUSTIN",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-05-13",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT8036",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Feb 8, 2021; 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.