| Elevate Total Wellness Llc | |
|
1647 Nashville Pike Gallatin TN 37066 | |
| (615) 714-8732 | |
| (615) 442-7725 |
| Full Name | Elevate Total Wellness Llc |
|---|---|
| Speciality | Physical Therapist |
| Location | 1647 Nashville Pike, Gallatin, Tennessee |
| Authorized Official Name and Position | Jesse Davenport (DIRECTOR) |
| Authorized Official Contact | 6157148732 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Elevate Total Wellness Llc 210 Baber Park West Suite 160 Gallatin TN 37066 Ph: (615) 461-7833 | Elevate Total Wellness Llc 1647 Nashville Pike Gallatin TN 37066 Ph: (615) 714-8732 |
| NPI Number | 1053041996 |
|---|---|
| Provider Enumeration Date | 06/14/2022 |
| Last Update Date | 02/22/2024 |
| Certification Date | 02/20/2024 |
| Medicare PECOS PAC ID | 8527442037 |
|---|---|
| Medicare Enrollment ID | O20220901002087 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053041996 | NPI | - | NPPES |
| Provider Name | Kristi A Roland |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1164498382 PECOS PAC ID: 1951315910 Enrollment ID: I20060128000041 |
| Provider Name | Jesse Davenport |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1851748958 PECOS PAC ID: 7315363983 Enrollment ID: I20200812003741 |
| Provider Name | Ian Crider |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1336524693 PECOS PAC ID: 7911215447 Enrollment ID: I20220901002309 |
| Provider Name | Michelle Jeannine Lineberry |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1104886456 PECOS PAC ID: 5799738118 Enrollment ID: I20230220000198 |
| Provider Name | Ana Laura Santanna Villalva |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1043090772 PECOS PAC ID: 7214384932 Enrollment ID: I20231116002880 |
| Provider Name | Jenny Williams |
|---|---|
| Provider Type | Practitioner - Physical Therapist In Private Practice |
| Provider Identifiers | NPI Number: 1073329843 PECOS PAC ID: 1153851100 Enrollment ID: I20250206001512 |
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