Individual provider Active NPI

Joshua Michael Brown, DPT, PT

  • Physical Therapist
  • Conyers, GA
National Provider Identifier
1013465251
Registry record updated Dec 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT012635 Issued in GA
Practice address
875 Flat Shoals Rd SE
#160
Conyers, GA 30094-6638
Phone
(770) 785-7669
NPI assigned
Sep 16, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2024

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 PT012635 GA Primary

Addresses

Primary practice location

875 Flat Shoals Rd SE
#160
Conyers, GA 30094-6638

Mailing address

694 Tahoe Cir
Stone Mountain, GA 30083-4450

Other practice location 1

495 Moreland Ave SE Ste B
Atlanta, GA 30316-1552
Phone (404) 883-2304

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181219001231 GA Practitioner - Physical Therapist in Private Practice 6709121775 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Intown Physical Therapy, LLCGroup PAC ID 4688817703, 4 clinicians

Practice addresses (Care Compare)

495 Moreland Ave SE
Suite B
Atlanta, GA 30316-1552
Phone (404) 883-2204

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT012635GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Intown Physical Therapy, LLC Physical Therapist CurrentSince Jan 13, 2023 Accepting new patients

Locations

495 Moreland Ave SE
Ste B
Atlanta, GA 30316
Phone (404) 883-2204

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": "1473984000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734480000000",
    "number": "1013465251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "694 TAHOE CIR",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300834450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 FLAT SHOALS RD SE",
            "address_2": "#160",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300946638",
            "telephone_number": "770-785-7669"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "495 Moreland Ave SE Ste B",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303161552",
            "country_code": "US",
            "telephone_number": "404-883-2304",
            "fax_number": "404-393-3270",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BROWN",
        "first_name": "JOSHUA",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-16",
        "last_updated": "2024-12-18",
        "certification_date": "2024-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2024; 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.