Provider Demographics
NPI:1598728875
Name:SHOPE, CATHERINE BOYD (PT)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:BOYD
Last Name:SHOPE
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:260 FORT SANDERS WEST BLVD
Mailing Address - Street 2:SUITE 110
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37922-3355
Mailing Address - Country:US
Mailing Address - Phone:865-769-4545
Mailing Address - Fax:865-769-4501
Practice Address - Street 1:260 FORT SANDERS WEST BLVD
Practice Address - Street 2:SUITE 110
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-3355
Practice Address - Country:US
Practice Address - Phone:865-769-4545
Practice Address - Fax:865-769-4501
Is Sole Proprietor?:No
Enumeration Date:2006-04-08
Last Update Date:2017-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN876225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN9161949OtherCIGNA
TN3659580Medicaid
TN4103294OtherBLUE CROSS BLUE SHIELD
TN4103294OtherBLUE CROSS BLUE SHIELD