Individual provider Active NPI

Clint Henley

  • Physical Therapist
  • Manchester, TN
National Provider Identifier
1861918302
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
585 Interstate Dr Ste a
Manchester, TN 37355-3191
Phone
(931) 723-7156
Fax
(931) 723-7159
NPI assigned
Aug 16, 2017
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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 TN Primary

Addresses

Primary practice location

585 Interstate Dr Ste a
Manchester, TN 37355-3191

Mailing address

PO Box 681478
Franklin, TN 37068-1478
Phone (615) 591-6590

Other identifiers 1

IdentifierTypeStateIssuer
446631MedicaidTN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250204002396 TN Practitioner - Physical Therapist in Private Practice 8022490440 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Broad River RehabilitationGroup PAC ID 3375801350, 210 clinicians

Practice addresses (Care Compare)

119 Bryan Ave
Manchester, TN 37355-2585
Phone (931) 345-2655

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Broad River Rehabilitation Physical Therapist CurrentSince Jan 29, 2025 Accepting new patients
Star Physical Therapy LP Past Accepting new patients
Star Physical Therapy LP Physical Therapist Past Accepting new patients

Locations

1 Pond St
Arden, NC 28704
Phone 82877452220027

119 Bryan Ave
Manchester, TN 37355
Phone (270) 993-4789

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1502841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1861918302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 681478",
            "city": "FRANKLIN",
            "state": "TN",
            "postal_code": "370681478",
            "telephone_number": "615-591-6590",
            "fax_number": "615-591-6601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 INTERSTATE DR STE A",
            "city": "MANCHESTER",
            "state": "TN",
            "postal_code": "373553191",
            "telephone_number": "931-723-7156",
            "fax_number": "931-723-7159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HENLEY",
        "first_name": "CLINT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-16",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "446631",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.