Mary K. Kearse, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6119 Issued in TN

Practice address

2910 Tazewell Pike
Knoxville, TN 37918-1879

Phone

(865) 687-1512

Fax

(865) 687-2138

NPI assigned

May 16, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Ms. Mary K. Wilson Former name

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Virginia Commonwealth University, School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Provision Physical TherapyGroup PAC ID 4082809603, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Provision Physical Therapy

  • Physical Therapy Clinic/Center
  • Knoxville, TN
  • NPI 1245551860
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1147737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1554681600000",
    "number": "1922050475",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1400 DOWELL SPRINGS BLVD",
            "address_2": "STE 120",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379092450",
            "telephone_number": "865-232-1415",
            "fax_number": "865-232-1416"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2910 TAZEWELL PIKE",
            "city": "KNOXVILLE",
            "state": "TN",
            "postal_code": "379181879",
            "telephone_number": "865-687-1512",
            "fax_number": "865-687-2138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KEARSE",
        "first_name": "MARY",
        "middle_name": "K.",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-16",
        "last_updated": "2019-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "6119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3652954",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "3154490",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE-RAILROAD GROUP ID",
            "identifier": "CH4394",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "WILSON",
            "middle_name": "K.",
            "prefix": "MS.",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• KDS Nutrition LLC
• Elizabeth Anne Kean-Groark, MD
• Christine Marie Kear, P.T.
• Gwendolyn Kear, CRNA
• Larissa Viola Kear, FNP
• Stephanie Lynne Keaton, BS
• Donald S Keeble, MD
• Catherine Keebler
• Emily Grace Keef, LPN
• Hannah Keefer, LCSW

• Physical Therapist in Knoxville, TN
• Providers in Knoxville, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2019; 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.