Individual provider Active NPI

Thomas Allen Pace, PT, DPT

  • Physical Therapist
  • Stockbridge, GA
National Provider Identifier
1003905175
Registry record updated Dec 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT008264 Issued in GA
Practice address
909 Eagles Landing Pkwy Ste 430
Stockbridge, GA 30281-6398
Phone
(770) 898-9993
Fax
(770) 898-9983
NPI assigned
Oct 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 4, 2017

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 PT008264 GA Primary

Addresses

Primary practice location

909 Eagles Landing Pkwy Ste 430
Stockbridge, GA 30281-6398

Mailing address

1617 Highway 20 W
McDonough, GA 30253-7311
Phone (770) 898-9993

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050308000434 GA Practitioner - Physical Therapist in Private Practice 1456305903 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pace Physical Therapy LLCGroup PAC ID 8628314150, 3 clinicians

Practice addresses (Care Compare)

1617 Hwy 20 W
McDonough, GA 30253-7311
Phone (770) 898-9993

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Pace Physical Therapy LLC Physical Therapist CurrentSince Jan 29, 2018 Accepting new patients

Locations

1617 Highway 20 W
McDonough, GA 30253
Phone (770) 898-9993

Organizations & group practices 1

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": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1512345600000",
    "number": "1003905175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1617 HIGHWAY 20 W",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302537311",
            "telephone_number": "770-898-9993",
            "fax_number": "770-898-9983"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "909 EAGLES LANDING PKWY STE 430",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816398",
            "telephone_number": "770-898-9993",
            "fax_number": "770-898-9983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PACE",
        "first_name": "THOMAS",
        "middle_name": "ALLEN",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2017-12-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008264",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 4, 2017; 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.