Individual provider Active NPI

Michael Brett Rolison, PT

  • Physical Therapist
  • Morristown, TN
National Provider Identifier
1861153694
Registry record updated Dec 8, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
14684 Issued in TN
Practice address
4329 W Andrew Johnson Hwy Ste 1
Morristown, TN 37814-1181
Phone
(423) 616-5965
Fax
(423) 616-5966
NPI assigned
Jan 4, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 8, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X P20220 NC
Physical Therapist 225100000X 14684 TN Primary

Addresses

Primary practice location

4329 W Andrew Johnson Hwy Ste 1
Morristown, TN 37814-1181

Mailing address

4329 W Andrew Johnson Hwy Ste 1
Morristown, TN 37814-1181
Phone (423) 616-5965

Other practice location 1

17001 Searstone Dr
Cary, NC 27513-8385
Phone (919) 234-0400

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230125002583 TN Practitioner - Physical Therapist in Private Practice 3678944816 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
14684TNMDPhysical Therapist
P20220NCMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fast Pace Medical Clinic PLLC CurrentSince Nov 3, 2022 Accepting new patients
Fast Pace Medical Clinic PLLC CurrentSince Nov 3, 2022 Accepting new patients

Locations

4329 W Andrew Johnson Hwy
Ste 1
Morristown, TN 37814
Phone (423) 616-5965

291 S Daisy St
Morristown, TN 37813
Phone (423) 616-8315

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": "1641254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670457600000",
    "number": "1861153694",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4329 W ANDREW JOHNSON HWY STE 1",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378141181",
            "telephone_number": "423-616-5965",
            "fax_number": "423-616-5966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4329 W ANDREW JOHNSON HWY STE 1",
            "city": "MORRISTOWN",
            "state": "TN",
            "postal_code": "378141181",
            "telephone_number": "423-616-5965",
            "fax_number": "423-616-5966"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "17001 Searstone Dr",
            "address_purpose": "LOCATION",
            "city": "Cary",
            "state": "NC",
            "postal_code": "275138385",
            "country_code": "US",
            "telephone_number": "919-234-0400",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROLISON",
        "first_name": "MICHAEL",
        "middle_name": "BRETT",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-01-04",
        "last_updated": "2022-12-08",
        "certification_date": "2022-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "NC",
            "license": "P20220",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "14684",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morristown, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.