Madison Misenheimer, OTR/L | |
263 E Broadway Blvd, Jefferson City, TN 37760-2810 | |
(865) 375-0880 | |
(423) 317-7773 |
Full Name | Madison Misenheimer |
---|---|
Gender | Female |
Speciality | Occupational Therapist |
Location | 263 E Broadway Blvd, Jefferson City, Tennessee |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1790407104 | NPI | - | NPPES |
7416 | Other | TN | LICENSE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | 7416 (Tennessee) | Primary |
Provider Name | Jordan C Black |
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Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
Provider Identifiers | NPI Number: 1528569316 PECOS PAC ID: 5890117469 Enrollment ID: O20200629000595 |
Mailing Address | Practice Location Address |
---|---|
Madison Misenheimer, OTR/L Po Box 608, Bean Station, TN 37708-0608 Ph: () - | Madison Misenheimer, OTR/L 263 E Broadway Blvd, Jefferson City, TN 37760-2810 Ph: (865) 375-0880 |
Claire Celeste Plunkett, Occupational Therapist Medicare: Medicare Enrolled Practice Location: 263 E Broadway Blvd, Jefferson City, TN 37760 Phone: 865-375-0880 Fax: 423-822-5514 | |
Mrs. Twana Elaine Mullins, OTR Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 710 W Ellis St, Jefferson City, TN 37760 Phone: 423-312-5181 | |
Lauren Taylor Collins, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 283 W Broadway Blvd, Jefferson City, TN 37760 Phone: 865-475-9037 |