Provider Demographics
NPI:1528026069
Name:ROBINSON, JON CHRISTOPHER (PT)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:CHRISTOPHER
Last Name:ROBINSON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:CHRIS
Other - Middle Name:
Other - Last Name:ROBINSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PT
Mailing Address - Street 1:5412 BLUERIDGE DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-8977
Mailing Address - Country:US
Mailing Address - Phone:865-384-3376
Mailing Address - Fax:
Practice Address - Street 1:2789 HIGHWAY 72 N STE B
Practice Address - Street 2:
Practice Address - City:LOUDON
Practice Address - State:TN
Practice Address - Zip Code:37774-5773
Practice Address - Country:US
Practice Address - Phone:865-234-8911
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2020-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN4890225100000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3658781Medicaid
TN3658781Medicaid
TN0677340003Medicare NSC
TN0677340010Medicare NSC
TN0677340005Medicare NSC
TN0677340004Medicare NSC
TN0677340001Medicare NSC