NPIMap

Organization Active NPI

Atlanta South Physical Therapy, Inc

  • Physical Therapist
  • Stockbridge, GA
National Provider Identifier
1013014208
Registry record updated Apr 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ATLANTA SOUTH PHYSICAL THERAPY, INC
Practice address
1233 Eagles Landing Pkwy
Suite a
Stockbridge, GA 30281-6399
Phone
(678) 289-0525
Fax
(678) 289-0529
NPI assigned
Sep 20, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2008

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

Authorized official

Name
Troy Bage
Title
President
Phone
(423) 238-7217

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1233 Eagles Landing Pkwy
Suite a
Stockbridge, GA 30281-6399

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

Other identifiers 1

IdentifierTypeStateIssuer
DD7784OtherGARAILROAD MEDICARE GROUP PROVIDER #

Other names 1

  • Rehab South Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050921001120 GA Part B Supplier - Clinic/Group Practice 1557395209 Receives reassigned benefits from 760 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Newnan, GA; Peachtree City, GA; Riverdale, GA; Snellville, GA; Stockbridge, GA; Cumming, GA; Jonesboro, GA; Fayetteville, GA…

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 16

National Provider Directory

National Provider Directory

Locations

1233 Eagles Landing Pkwy
Ste A
Stockbridge, GA 30281
Phone (404) 480-3842

NPI Registry JSON

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

{
    "created_epoch": "1158710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1209427200000",
    "number": "1013014208",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1233 EAGLES LANDING PKWY",
            "address_2": "SUITE A",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302816399",
            "telephone_number": "678-289-0525",
            "fax_number": "678-289-0529"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTA SOUTH PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-20",
        "last_updated": "2008-04-29",
        "status": "A",
        "authorized_official_last_name": "BAGE",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-238-7217"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE GROUP PROVIDER #",
            "identifier": "DD7784",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rehab South",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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 Apr 29, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.