Madison Rayeann Sietsema, PTA
Individual provider Active NPI Physical Therapy Assistant · Pleasant Hill, TN
NPI 1972076479 · NPPES record last updated Jan 7, 2019
Key facts
- NPI
- 1972076479
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapy Assistant 225200000X
- License
- 6454 (TN)
- Practice address
- 55 W Lake Rd
Pleasant Hill, TN 38578-3002 - Phone
- (931) 223-4965
- NPI assigned
- Jan 7, 2019
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6454 | TN | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | 6454 | TN | Yes |
Addresses
Primary practice location
55 W Lake Rd
Pleasant Hill, TN 38578-3002
Mailing address
55 W Lake Rd
Pleasant Hill, TN 38578-3002
Other providers in Pleasant Hill, TN
- Coy Daniel Kidd
- Joshua Manis
- Jessica Lynn Oliver
- James Elliott Peck
- Helen Denise Reagan
- Deonna Deanna Turner
- Uplands Retirement Village
- Uplands Village
- Uplands Village
All providers in Pleasant Hill, TN · Physical Therapy Assistant in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2019. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.