Melanie Ruth Wortman

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT0000002319 Issued in TN

Practice address

501A Westfield PL
Jasper, TN 37347-5144

Phone

(423) 942-3009

Fax

(423) 942-3099

NPI assigned

May 19, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Southern Rehab & Aquatics

  • Physical Therapist
  • Kimball, TN
  • NPI 1760502520
  Medicare reassignment NPD
• Physical Therapy Associates of Chattanooga, Inc

  • Specialist
  • Chattanooga, TN
  • NPI 1396817383

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1147996800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1932153624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 DIXIE LEE CENTER RD",
            "city": "KIMBALL",
            "state": "TN",
            "postal_code": "373475672",
            "telephone_number": "423-837-7536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "501A WESTFIELD PL",
            "city": "JASPER",
            "state": "TN",
            "postal_code": "373475144",
            "telephone_number": "423-942-3009",
            "fax_number": "423-942-3099"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WORTMAN",
        "first_name": "MELANIE",
        "middle_name": "RUTH",
        "name_prefix": "Mrs.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-19",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "2319",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "PT0000002319",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "62-1407143",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUECROSS BLUESHIELD OF T",
            "identifier": "3110918",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "621407143",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Christopher Brian Walls, NP-C
• Pamela Louise West, APN
• Marshall Ray Willis, MD
• Benjamin M Willy, ATC
• Janet Elaine Winnie, RN, BS
• Jana Zimmerman

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2024; 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.