Unknown Individual – Physical Therapist, NPI 1255428702

Unknown Individual is a healthcare provider. based in Cookeville, Tennessee. specializing in Physical Therapist. They hold a License No. 5421 (TN). The NPI Number for Unknown Individual is 1255428702

Main info

Organization
Inactive
29 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1255428702
Phone
(931) 528-0042
Address
851 S Willow Ave
Deactivation Date
20 December 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6158966866
Graduation Year
1997 (29 years ago)
PAC ID
7618005083
Group Practice PAC ID
3375454648
Professional Enrollment ID
I20100505000278
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

Provider Addresses for Unknown Individual

  • 851 S Willow Ave

    Ste 110

    Cookeville, TN 38501

    Phone: (931) 528-0042

    Type: Location

  • Crescent Centre Drive, Franklin, Williamson County, Tennessee, 37067, United States

    FRANKLIN, TN 370677285

    Phone: (615) 373-1350

    Fax: (615) 221-9054

    Type: Mailing

  • 851, South Willow Avenue, Green Acres, Cookeville, Putnam County, Tennessee, 38501, United States

    STE 110

    COOKEVILLE, TN 38501

    Phone: (931) 528-0042

    Type: Location

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.

No Medicare enrollment or revalidation data available for this provider in our database.

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 38501)

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Provider's Procedures

Unknown Individual performs procedures in Physical Therapist. See the list of HCPCS codes below.
SpecialtyPractice State
HCPCS Code
Description
Service Count
Beneficiary Count
PHYSICAL THERAPYTN97001Physical therapy evaluation7471
PHYSICAL THERAPYTN97110Therapeutic exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes1151132
PHYSICAL THERAPYTN97140Manual (physical) therapy techniques to 1 or more regions, each 15 minutes688122

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: 3375454648View full group profile
NameSpecialtyState
-TN
-TN
Physical Therapist In Private PracticeLA
Physical Therapist In Private PracticePA
-TN
Physical Therapist In Private PracticeAL
Physical Therapist In Private PracticeMN
-TN
-TN
-TX

Reviews

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Frequently asked questions

What is Unknown Individual's NPI number?
Unknown Individual's NPI is 1255428702 — the number used across U.S. healthcare to identify this provider.
Is Unknown Individual still active if the NPI shows inactive?
NPPES shows Unknown Individual as inactive; dates on the record explain the timeline when available.
What clinical focus is listed for Unknown Individual?
At a glance, Unknown Individual is tied to Physical Therapist. Clinical services aligned with this taxonomy classification.
What locale is associated with Unknown Individual?
Directory geography for Unknown Individual centers on Cookeville, Tennessee.
Does Unknown Individual accept insurance?
Insurance participation is not part of the core NPI extract — call the plan or office to confirm.

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