Provider Demographics
NPI:1659322139
Name:WINNINGHAM, DANA E (PT)
Entity type:Individual
Prefix:MR
First Name:DANA
Middle Name:E
Last Name:WINNINGHAM
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4109 MOUNTAIN VIEW AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37415-2096
Mailing Address - Country:US
Mailing Address - Phone:423-842-9322
Mailing Address - Fax:866-591-0619
Practice Address - Street 1:7808 MONTVUE CENTER WAY
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37919-5574
Practice Address - Country:US
Practice Address - Phone:865-392-1033
Practice Address - Fax:866-591-0619
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2025-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN7357225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3645987Medicaid
TN3645987Medicaid
TN4113340OtherBLUE CROSS
TN3645987Medicaid