Individual provider Active NPI

Nicole Marie Cresswell, MSPT

  • Physical Therapist
  • Madisonville, TN
National Provider Identifier
1922048347
Registry record updated Sep 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT0000004777 Issued in TN
Practice address
4249 Highway 411
Ste 4
Madisonville, TN 37354-1544
Phone
(423) 436-0309
Fax
(423) 436-0310
NPI assigned
Jun 7, 2006
Last updated
Sep 3, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2015

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 PT0000004777 TN Primary

Addresses

Primary practice location

4249 Highway 411
Ste 4
Madisonville, TN 37354-1544

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-8930

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20151103002141 TN Practitioner - Physical Therapist in Private Practice 0345226726 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
University of Miami, LM Miller School of Medicine, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians

Practice addresses (Care Compare)

5220 Park Ave
Suite 201
Memphis, TN 38119-3549
Phone (901) 683-9630

878 Hwy 411 N
Etowah, TN 37331-1912
Phone (423) 263-7070

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT0000004777TNMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy, LLC Physical Therapist CurrentSince Sep 4, 2015 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Dec 5, 2022 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Dec 5, 2022 Accepting new patients
Physical Therapy of Tellico, LLC Physical Therapist PastSince Jun 26, 2004 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (866) 518-0283

1202 N Charles G Seivers Blvd
Ste A
Clinton, TN 37716
Phone (865) 457-0192

3493 Veterans Dr N
Ste D
Huntingdon, TN 38344
Phone (731) 209-4444

820 Scenic Hwy
Ste B
Lookout Mtn, TN 37350
Phone (423) 825-1393

4249 Highway 411
Ste 4
Madisonville, TN 37354
Phone (423) 436-0309

5220 Park Ave
Ste 201
Memphis, TN 38119
Phone (901) 683-9630

8823 Production Ln
Ooltewah, TN 37363
Phone (423) 238-8930

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": "1149638400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441238400000",
    "number": "1922048347",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-8930",
            "fax_number": "423-285-6647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4249 HIGHWAY 411",
            "address_2": "STE 4",
            "city": "MADISONVILLE",
            "state": "TN",
            "postal_code": "373541544",
            "telephone_number": "423-436-0309",
            "fax_number": "423-436-0310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRESSWELL",
        "first_name": "NICOLE",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-07",
        "last_updated": "2015-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT0000004777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madisonville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2015; 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.