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BILL ISSA BAKARY DJIRE
Complete NPI Record 1770166100
Physical Therapist in Chattanoooga, TN

NPI Status: Active since May 03, 2021

Contact Information

1201 MARKET STREET, SUITE A
CHATTANOOOGA, TN
ZIP 37402
Phone: (423) 648-4490
Fax: (423) 648-4491

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider First Line Business Mailing Address
  7. Provider Business Mailing Address City Name
  8. Provider Business Mailing Address State Name
  9. Provider Business Mailing Address Postal Code
  10. Provider Business Mailing Address Country Code If outside U S
  11. Provider Business Mailing Address Telephone Number
  12. Provider First Line Business Practice Location Address
  13. Provider Business Practice Location Address City Name
  14. Provider Business Practice Location Address State Name
  15. Provider Business Practice Location Address Postal Code
  16. Provider Business Practice Location Address Country Code If outside U S
  17. Provider Business Practice Location Address Telephone Number
  18. Provider Business Practice Location Address Fax Number
  19. Provider Enumeration Date
  20. Last Update Date
  21. Provider Gender Code
  22. Healthcare Provider Taxonomy Code 1
  23. Provider License Number 1
  24. Provider License Number State Code 1
  25. Healthcare Provider Primary Taxonomy Switch 1
  26. Is Sole Proprietor
  27. NPI Certification Date

Complete NPI Dataset

This page represents the complete record for NPI 1770166100. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1770166100
The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
Entity Type Code: 1
The city name in the location address of the provider being identified.
The State code in the location of the provider being identified.
Provider First Name: BILL
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Middle Name: ISSA BAKARY
The country code in the location address of the provider being identified.
Provider First Line Business Mailing Address: 4477 PINERIDGE CIR
The date the provider was assigned a unique identifier (assigned an NPI).
Provider Business Mailing Address City Name: DUNWOODY
The date that a record was last updated or changed.
Provider Business Mailing Address State Name: GA
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Business Mailing Address Postal Code: 303386540
The telephone number associated with the location address of the provider being identified.
Provider Business Mailing Address Country Code If outside U S : US
The date the provider was assigned a unique identifier (assigned an NPI).
Provider Business Mailing Address Telephone Number: 4045328714
The date that a record was last updated or changed.
Provider First Line Business Practice Location Address: 1201 MARKET STREET, SUITE A
The code designating the provider’s gender if the provider is a person.
Provider Business Practice Location Address City Name: CHATTANOOOGA
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider Business Practice Location Address State Name: TN
The State code in the location of the provider being identified.
Provider Business Practice Location Address Postal Code: 374027081
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
Provider Business Practice Location Address Country Code If outside U S : US
The middle name of the provider, if the provider is an individual.
Provider Business Practice Location Address Telephone Number: 4236484490
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider Business Practice Location Address Fax Number: 4236484491
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Enumeration Date: 5/3/2021
The city name in the mailing address of the provider being identified.
Last Update Date: 4/8/2024
The State or Province name in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address State name’’.
Provider Gender Code: M
The postal ZIP or zone code in the mailing address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. This data element may contain the same information as ‘‘Provider location address postal code’’.
Healthcare Provider Taxonomy Code 1: 225100000X
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider License Number 1: 13327
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: TN
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
Is Sole Proprietor: N
The last name of the provider. If the provider is an individual, this is the legal name.
NPI Certification Date: 4/8/2024