MR. LEO TAGBAR SUMATRA (NPI# 1497017578) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497017578 |
| Entity Type | Individual |
| Full Name | MR. LEO TAGBAR SUMATRA |
| Practice Address |
13135 Lebanon Rd Mount Juliet TN 37122-2873 |
| Practice Telephone | 6155549224 |
| Mailing Telephone | 6155549224 |
| Enumeration Date | 2012-06-13 |
| Last Update Date | 2012-06-13 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251G0304X |
Physical Therapist Specialization: Geriatrics |
PT1965 | TN | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
13135 LEBANON RD |
| City | MOUNT JULIET |
| State | TN |
| Zip Code | 37122-2873 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720628084 | Your Motion Physical Therapy Pllc | Physical Therapist | 102 Vanner Rd, Mt. Juliet, TN 37122 | 2020-01-14 |
| 1639728355 | Brantley Allen Thigpen | Student in an Organized Health Care Education/Training Program | 2128, Fellowshid Rd, Mount Juliet, TN 37122 | 2019-09-05 |
| 1811479272 | Jessica Danielle Parker | Nurse Practitioner | 854 N Mt Juliet Road, Mt Juliet, TN 37122 | 2018-09-02 |
| 1952891798 | Twin Lakes Dental Care Pllc | Clinic/Center | 11315 Lebanon Rd, Mount Juliet, TN 37122 | 2018-05-17 |
| 1346768983 | William Siegel | Chiropractor | 650 S. Mount Juliet Rd. Suite 105, Mount Juliet, TN 37122 | 2017-09-04 |
| 1194269506 | Michele Mcdermitt | Nurse Practitioner | 108 Providence Trail, Mt. Juliet, TN 37122 | 2016-12-05 |
| 1720537491 | Mt. Juliet Dental Group, PC | Dentist | 4155 N Mt Juliet Rd, Mt. Juliet, TN 37122 | 2016-09-23 |
| 1407302169 | Comprehensive Neurology Center, Pllc | Psychiatry & Neurology | 5000 Crossings Cir Ste 101, Mt Juliet, TN 37122 | 2016-08-31 |
| 1639624109 | Samantha Nicole Grishaber | Occupational Therapist | 5000 Crossing Circle, Suite 100, Mount Juliet, TN 37122 | 2016-08-24 |
| 1033584461 | Kimberly Campbell | Nurse Practitioner | 3500 N Mount Juliet Rd Ste 201, Mt Juliet, TN 37122 | 2015-12-10 |
| Find all providers in zip 37122 | ||||
| Taxonomy Code | 2251G0304X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Geriatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417506262 | Therapy On The Move | Physical Therapist | 5371 Highway 297, Pioneer, TN 37847-4282 | 2019-09-04 |
| 1649838517 | Lindsay Carter Jones | Physical Therapist | 901 Teasel Dr, Kingsport, TN 37660-3261 | 2019-06-05 |
| 1932540648 | Elena Maria Miller | Physical Therapist | 581 Zachary Ln, Jackson, TN 38305-5679 | 2013-07-10 |
| 1619315942 | Kelsey Martha Humphrey | Physical Therapist | 4384 Conger Rd, Louisville, TN 37777-5118 | 2013-06-09 |
| 1801131610 | Emma Hernandez Tenerife | Physical Therapist | 505 Buchanan Road, New Tazewell, TN 37825 | 2012-12-05 |
| 1952682700 | I Karen Howard | Physical Therapist | 808 Circle Hill Dr, Selmer, TN 38375-2292 | 2011-09-07 |
| 1942507850 | Megan Mayeux Smith | Physical Therapist | 2317 Us Highway 411 S, Maryville, TN 37801-8634 | 2011-02-13 |
| 1548454721 | Sean Frederick Preiss | Physical Therapist | 721 Mcguffeys Dr, Knoxville, TN 37934-8204 | 2007-08-30 |
| 1073125662 | Rehab At Your Space, LLC | Physical Therapist | 6320 N Quail Hollow Rd, Memphis, TN 38120-1420 | 2020-08-17 |
| 1346873981 | Francisco D Nayan Jr. | Physical Therapist | 856 Willow Tree Cir, Cordova, TN 38018-6376 | 2020-02-21 |
| Find all providers with the same taxonomy | ||||
| City | MOUNT JULIET |
| Zip Code | 37122 |
Please comment or provide details below to improve the information on MR. LEO TAGBAR SUMATRA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.