Individual provider Active NPI

Marcus Roberts, PT, DPT

  • Physical Therapist
  • Thomasville, GA
National Provider Identifier
1003460015
Registry record updated Jul 29, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
223 S Crawford St
Thomasville, GA 31792-5504
Phone
(229) 236-8989
Fax
(229) 238-8990
NPI assigned
Jul 29, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

223 S Crawford St
Thomasville, GA 31792-5504

Mailing address

PO Box 5906
Thomasville, GA 31758-5906
Phone (229) 236-8989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20191015001606 GA Practitioner - Physical Therapist in Private Practice 4587995089 Reassigns benefits to 1 organization
I20220921002285 FL Practitioner - Physical Therapist in Private Practice 4587995089 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1303 S Jefferson St
Monticello, FL 32344-1635
Phone (850) 321-4443

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Big Oak Physical Therapy, LLC CurrentSince Aug 16, 2019 Accepting new patients
Monticello Physical Therapy & Wellness Physical Therapist CurrentSince Aug 31, 2022 Accepting new patients

Locations

1303 S Jefferson St
Monticello, FL 32344
Phone (850) 321-4443

223 S Crawford St
Thomasville, GA 31792
Phone (229) 236-8989

1233 E Jackson St
Thomasville, GA 31792
Phone (229) 236-8989

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1564358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1564358400000",
    "number": "1003460015",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5906",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317585906",
            "telephone_number": "229-236-8989",
            "fax_number": "229-236-8990"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "223 S CRAWFORD ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317925504",
            "telephone_number": "229-236-8989",
            "fax_number": "229-238-8990"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "MARCUS",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-29",
        "last_updated": "2019-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.