Individual provider Active NPI

Natalie Koontz Harris, DPT

  • Physical Therapist
  • Perry, GA
National Provider Identifier
1013187897
Registry record updated Jul 3, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
902 Northside Dr
Perry, GA 31069-3344
Phone
(478) 987-1610
Fax
(478) 987-1640
NPI assigned
Mar 7, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2013

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 GA Primary

Addresses

Primary practice location

902 Northside Dr
Perry, GA 31069-3344

Mailing address

5790 Coody Dairy Rd
Vienna, GA 31092-6104
Phone (229) 273-3053

Other identifiers 1

IdentifierTypeStateIssuer
598119283CMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1204848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372809600000",
    "number": "1013187897",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5790 COODY DAIRY RD",
            "city": "VIENNA",
            "state": "GA",
            "postal_code": "310926104",
            "telephone_number": "229-273-3053"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 NORTHSIDE DR",
            "city": "PERRY",
            "state": "GA",
            "postal_code": "310693344",
            "telephone_number": "478-987-1610",
            "fax_number": "478-987-1640"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "NATALIE",
        "middle_name": "KOONTZ",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-03-07",
        "last_updated": "2013-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "598119283C",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Perry, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.