SAMUEL LATENDRESSE (DPT) – Physical Therapist, NPI 1124707823

SAMUEL LATENDRESSE (DPT) is a healthcare provider. based in Lexington, Tennessee. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT. The NPI Number for SAMUEL LATENDRESSE (DPT) is 1124707823

Main info

Male
3 Years Of Experience
Accepts Medicare Assignment
Name
SAMUEL LATENDRESSE (DPT)
NPI
1124707823
Phone
Not provided
Address
337 WEST CHURCH STREET
Enumeration Date
12 July 2023
Last Update Date
12 July 2023

Doctor Profile

Medical School Name
UNIVERSITY OF TENNESSEE, HSC, COLLEGE OF MEDICINE
Secondary Phone
7315841722
Graduation Year
2023 (3 years ago)
PAC ID
5799211868
Group Practice PAC ID
5193873933
Professional Enrollment ID
I20241212001749
Address ID
TN383203011CA309XXNXXX400
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience19
Completeness75
Years active:2State licenses:0Digital endpointsOther names

2,335 PHYSICAL THERAPIST IN PRIVATE PRACTICE in TN

Provider Addresses for SAMUEL LATENDRESSE (DPT)

  • 337 WEST CHURCH STREET

    LEXINGTON, TN 38351

    Phone:

    Type: Location

  • PO BOX 681478

    FRANKLIN, TN 370681478

    Phone: (615) 591-6590

    Fax: (615) 591-6601

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-12-12

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20241212001749IPhysical Therapist In Private PracticeTNTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 38351)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 5193873933View full group profile
NameSpecialtyState
Physical Therapist In Private PracticeTN
Physical Therapist In Private PracticeTN
Physical Therapist In Private PracticeTN
Physical Therapist In Private PracticeTN
Physical Therapist In Private PracticeTN
Physical Therapist In Private PracticeTN
Occupational Therapist In Private PracticeTN
Physical Therapist In Private PracticeTN
-TN
Physical Therapist In Private PracticeTN

Reviews

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Frequently asked questions

What NPI should I save for SAMUEL LATENDRESSE (DPT)?
Save NPI 1124707823 if you need a stable reference for SAMUEL LATENDRESSE (DPT).
Is SAMUEL LATENDRESSE (DPT)'s enrollment marked active?
An active flag here means the NPI record is not in a deactivated state.
What kind of provider is SAMUEL LATENDRESSE (DPT)?
The page reflects Physical Therapist for SAMUEL LATENDRESSE (DPT). Clinical services aligned with this taxonomy classification.
What location metadata exists for SAMUEL LATENDRESSE (DPT)?
The page summarizes Lexington, Tennessee for SAMUEL LATENDRESSE (DPT); expand the address list for detail.
How can I contact SAMUEL LATENDRESSE (DPT)?
Phone or fax may appear on the official NPI record when supplied — verify before relying on them.

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