Samuel Latendresse, DPT
NPI 1124707823ActiveIndividual· Physical Therapist· Lexington, TN
Physical Therapist (DPT) in Lexington, Tennessee, trained at University of Tennessee, Hsc, College of Medicine (class of 2023). Enrolled in Medicare as practitioner - physical therapist in private practice.
Overview
| NPI | 1124707823 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | DPT |
| Sole proprietor | No |
| NPI issued | Jul 12, 2023 |
| Last updated in NPPES | Jul 12, 2023 |
| Certified by provider | Jul 6, 2023 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Physical Therapist Primary | 225100000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 10, 2026 | No match | — |
| New York OMIG · Nov 10, 2026 | No match | — |
| Ohio Medicaid · Nov 10, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 10, 2026 | No match | — |
| Washington HCA · Nov 10, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Practitioner - Physical Therapist in Private Practice (TN) |
|---|
Education and affiliations
| Medical school | University of Tennessee, Hsc, College of Medicine |
|---|---|
| Graduation year | 2023 |
| Medicare specialty | Physical Therapist In Private Practice |
Medical group
- Dynamix Physical Therapy LLCMilan, TN · 46 clinicians
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