Tara Marie Yelliott, PT, DPT
Individual provider Active NPI Physical Therapist · MC Donald, TN
NPI 1962845776 · NPPES record last updated Apr 10, 2013
Key facts
- NPI
- 1962845776
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- 7740 (TN)
- Practice address
- 200 Natures TRL
MC Donald, TN 37353-5172 - Phone
- (423) 339-2517
- NPI assigned
- Apr 10, 2013
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 3
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20220930001521 | TN | Practitioner - Physical Therapist in Private Practice | 6901282755 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT009768 | GA | MD | Physical Therapist |
| 7740 | TN | MD | Occupational Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Can DO Kids Pediatric Therapy Services, LLC | Physical Therapist | Current |
Accepting new patients |
| The Speech and Hearing Center | Physical Therapist | Current |
Accepting new patients |
| Signal Centers Inc | Current |
Accepting new patients |
Locations
2212 Encompass Dr
Ste 148
Chattanooga, TN 37421
Phone (423) 622-6900
65 Mouse Creek Rd NW
Cleveland, TN 37312
Phone (423) 472-9944
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 7740 | TN | Yes |
| Physical Therapist | 225100000X | PT009768 | GA |
Addresses
Primary practice location
200 Natures TRL
MC Donald, TN 37353-5172
Mailing address
7576 Lacie Jay LN
Ooltewah, TN 37363-9520
Phone (540) 336-6017
Other providers in MC Donald, TN
All providers in MC Donald, TN · Physical Therapist in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 10, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.