SOUTHERN REHAB & AQUATICS
NPI 1760502520
Physical Therapist in Kimball, TN

NPI Status: Active since March 29, 2007

Contact Information

400 DIXIE LEE CENTER RD
SUITE A
KIMBALL, TN
ZIP 37347
Phone: (423) 837-7536
Fax: (423) 837-7538

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  • Organization
  • Physical Therapist
  • Accepts Insurance

About SOUTHERN REHAB & AQUATICS

This page provides the complete NPI Profile along with additional information for Southern Rehab & Aquatics, a provider established in Kimball, Tennessee operating as a Physical Therapist. The healthcare provider is registered in the NPI registry with number 1760502520 assigned on March 2007. The practitioner's primary taxonomy code is 225100000X with license number PT0000006009 (TN). The provider is registered as an organization and their NPI record was last updated 18 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mr. Trace Dewayne Kennemore Pt (Pt)

NPI
1760502520
Provider Name
SOUTHERN REHAB & AQUATICS
Entity Type
Organization
Location Address
400 DIXIE LEE CENTER RD SUITE A KIMBALL, TN 37347
Location Phone
(423) 837-7536
Location Fax
(423) 837-7538
Mailing Address
400 DIXIE LEE CENTER RD KIMBALL, TN 37347
Mailing Phone
(423) 837-7536
Mailing Fax
(423) 837-7538
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-29-2007
Last Update Date
04-28-2008
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physical Therapist

Taxonomy Code
225100000X
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
License No.
PT0000006009
License State
TN
Taxonomy Description
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • SoloCare Bronze EPO $8500 DED HSA 10004 - EPO
  • SoloCare Exp Bronze EPO $9500 DED 10015 - EPO
  • SoloCare Gold EPO $1500 DED 10010 - EPO
  • SoloCare Silver EPO $5000 DED 10014 - EPO
  • SoloCare Silver EPO $6500 DED 10013 - EPO
  • SoloCare Standard Exp Bronze EPO $7500 DED 10008 - EPO
  • SoloCare Standard Gold EPO $2000 DED 10006 - EPO
  • SoloCare Standard Platinum EPO $0 DED 10005 - EPO
  • SoloCare Standard Silver EPO $6000 DED 10007 - EPO

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. TRACE DEWAYNE KENNEMORE PT

Authorized Official Title
PT
Authorized Official Phone
(423) 837-7536

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
3732180MEDICARE ID-TYPE UNSPECIFIED (04)TN 

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1760502520, we treat the final digit (0) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 50. The final step is to find the difference between that total and the next multiple of ten (50 - 50 = 0).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
7
Unchanged
Pos 3
6
Doubled → 12 → 1 + 2
Pos 4
0
Unchanged
Pos 5
5
Doubled → 10 → 1 + 0
Pos 6
0
Unchanged
Pos 7
2
Doubled → 4
Pos 8
5
Unchanged
Pos 9
2
Doubled → 4
Check
0
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 6 → 12 → 3 5 → 10 → 1 2 → 4 2 → 4

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 7 + 1 + 2 + 0 + 1 + 0 + 0 + 4 + 5 + 4 + 24 = 50

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 50 is 50. The difference is the calculated check digit.

50 - 50 = 0
This NPI is valid
The calculated check digit is 0, which matches the last digit of 1760502520.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Physical Therapist
400 DIXIE LEE CENTER RD
KIMBALL, TN 37347
Dermatology
400 DIXIE LEE CENTER RD, SUITE C
KIMBALL, TN 37347
Physical Therapist
400 DIXIE LEE CENTER RD, SUITE A
KIMBALL, TN 37347
Physical Therapist
400 DIXIE LEE CENTER RD, SUITE A
KIMBALL, TN 37347

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1760502520, enumerated as an "organization" on March 29, 2007.

The provider is located at 400 DIXIE LEE CENTER RD SUITE A KIMBALL, TN 37347 and the phone number is (423) 837-7536.

Physical Therapist with taxonomy code 225100000X.

The provider might be accepting Accepts: Alliant Health Plans, Inc., Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.