Provider Demographics
NPI:1972552974
Name:PURVIS, SHERRY ANN (PT, BSPT)
Entity type:Individual
Prefix:
First Name:SHERRY
Middle Name:ANN
Last Name:PURVIS
Suffix:
Gender:F
Credentials:PT, BSPT
Other - Prefix:
Other - First Name:SHERRY
Other - Middle Name:A
Other - Last Name:PITTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6397 LEE HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:CHATTANOOGA
Mailing Address - State:TN
Mailing Address - Zip Code:37421-2564
Mailing Address - Country:US
Mailing Address - Phone:423-238-7217
Mailing Address - Fax:423-238-3473
Practice Address - Street 1:827 NE LAKEWOOD BLVD
Practice Address - Street 2:
Practice Address - City:LEES SUMMIT
Practice Address - State:MO
Practice Address - Zip Code:64064-1366
Practice Address - Country:US
Practice Address - Phone:816-533-6931
Practice Address - Fax:816-350-3925
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2019-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO02259225100000X
KS11-03933225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOMA4370052OtherMEDICARE PTAN
34346103OtherBCBS KC
KSKA2868041OtherMEDICARE PTAN
MO34346063OtherBCBS
MOK86B00017Medicare PIN