Individual provider Active NPI

Lindsey Purvis Michelotti, DPT

  • Orthopedic Physical Therapist
  • Milan, TN
National Provider Identifier
1861037764
Registry record updated Nov 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
12320 Issued in TN
Practice address
2060 Rhino Xing
Milan, TN 38358-5201
Phone
(731) 613-2214
NPI assigned
Nov 14, 2019
Last updated
Nov 14, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 14, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X 12320 TN Primary

Addresses

Primary practice location

2060 Rhino Xing
Milan, TN 38358-5201

Mailing address

2060 Rhino Xing
Milan, TN 38358-5201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200109002319 TN Practitioner - Physical Medicine and Rehabilitation 5890120380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Other, 2019
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
12320TNMDNephrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Current Accepting new patients
Aegis Group Practice LLC CurrentSince Jun 26, 2024 Accepting new patients
Aegis Group Practice LLC CurrentSince Jun 26, 2024 Accepting new patients
Kerry D. Friesen, M.D. 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": "1573689600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573689600000",
    "number": "1861037764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2060 RHINO XING",
            "city": "MILAN",
            "state": "TN",
            "postal_code": "383585201"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2060 RHINO XING",
            "city": "MILAN",
            "state": "TN",
            "postal_code": "383585201",
            "telephone_number": "731-613-2214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHELOTTI",
        "first_name": "LINDSEY",
        "middle_name": "PURVIS",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-14",
        "last_updated": "2019-11-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "TN",
            "license": "12320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milan, TN

Sources for this page

Verify at the official NPI Registry.