Basic Information
Provider Information
NPI: 1730371493
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROGERS
FirstName: TAMMY
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: P.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2400 PATTERSON ST
Address2: SUITE 100
City: NASHVILLE
State: TN
PostalCode: 372031562
CountryCode: US
TelephoneNumber: 6153420038
FaxNumber:  
Practice Location
Address1: 2400 PATTERSON ST
Address2: SUITE 100
City: NASHVILLE
State: TN
PostalCode: 372031562
CountryCode: US
TelephoneNumber: 6153420038
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/15/2007
LastUpdateDate: 11/13/2014
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225100000XPT5090TNY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 
225100000XPT004918KYN Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist 

No ID Information.


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