Active NPI
Thomas Vantrease III, PTA
- Physical Therapy Assistant
- Hendersonville, TN
National Provider Identifier
1902202617
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- 5825
- Practice address
- 110 Glen Oak CT E
Hendersonville, TN 37075-3052 - Phone
- (615) 969-4361
- NPI assigned
- Nov 6, 2014
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 5825 | TN | Primary |
| Massage Therapist | 225700000X | 4302 | TN |
Addresses
Primary practice location
110 Glen Oak CT E
Hendersonville, TN 37075-3052
Mailing address
110 Glen Oak CT E
Hendersonville, TN 37075-3052
Phone (615) 969-4361
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4302 | TN | MD | Occupational Therapy Assistant |
| 5825 | TN | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1415232000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1415232000000",
"number": "1902202617",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "110 GLEN OAK CT E",
"city": "HENDERSONVILLE",
"state": "TN",
"postal_code": "370753052",
"telephone_number": "615-969-4361"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "110 GLEN OAK CT E",
"city": "HENDERSONVILLE",
"state": "TN",
"postal_code": "370753052",
"telephone_number": "615-969-4361"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VANTREASE",
"first_name": "THOMAS",
"name_suffix": "III",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-11-06",
"last_updated": "2014-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "TN",
"license": "5825",
"primary": true
},
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "TN",
"license": "4302",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hendersonville, TN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.