Proactive Alliance Therapy & Wellness, PLLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PROACTIVE ALLIANCE THERAPY & WELLNESS, PLLC

Practice address

181 Hatcher LN
Clarksville, TN 37043-5987

Phone

(731) 335-2117

NPI assigned

Mar 18, 2024

Last updated

Mar 18, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Jacob Clinton Hamrick, PT, DPTNPI 1720413602

Title

Owner

Phone

(731) 335-2117

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jacob Hamrick, PT, DPT

  • Physical Therapist
  • Clarksville, TN
  • NPI 1720413602
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1710720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1710720000000",
    "number": "1932968385",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "377 FANTASY LN",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370431753",
            "telephone_number": "731-335-2117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "181 HATCHER LN",
            "city": "CLARKSVILLE",
            "state": "TN",
            "postal_code": "370435987",
            "telephone_number": "731-335-2117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE ALLIANCE THERAPY & WELLNESS, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-18",
        "last_updated": "2024-03-18",
        "certification_date": "2024-03-18",
        "status": "A",
        "authorized_official_last_name": "HAMRICK",
        "authorized_official_first_name": "JACOB",
        "authorized_official_middle_name": "CLINTON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "731-335-2117",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• William W Prine, MD
• Willie Pringle
• Elizabeth E Pritchett, M.D.
• Privia Medical Group Tennessee LLC (Sports Ortho Urgent Care)
• Privia Medical Group Tennessee LLC (Sports Ortho Urgent Care)
• Proactive Transportation LLC
• Taiylor Maree Proberts
• Angela Proctor, PTA
• Jill T. Proctor, ANP
• Vincent Michael Proctor, PA-C

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 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.