Individual provider Active NPI

Calvin Colston Wilbanks

  • Physical Therapist
  • Demorest, GA
National Provider Identifier
1013748508
Registry record updated Dec 8, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT017286 Issued in GA
Practice address
590 441 Historic Hwy N Ste E
Demorest, GA 30535-4561
Phone
(706) 754-6611
NPI assigned
Aug 8, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2025

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 PT017286 GA Primary

Addresses

Primary practice location

590 441 Historic Hwy N Ste E
Demorest, GA 30535-4561

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (866) 518-0283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20241107004051 GA Practitioner - Physical Therapist in Private Practice 4082148424 Reassigns benefits to 3 organizations
I20250611000488 ID Practitioner - Physical Therapist in Private Practice 4082148424 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independent Physical Therapy of Georgia, LLC 526 clinicians

Practice addresses (Care Compare)

590 441 Historic Hwy N
Suite E
Demorest, GA 30535-4561
Phone (706) 754-6611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Agilitas USA, Inc Physical Therapist CurrentSince Aug 26, 2024 Accepting new patients
Benchmark Physical Therapy Inc Physical Therapist CurrentSince Aug 26, 2024 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Aug 26, 2024 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Aug 26, 2024 Accepting new patients
Benchmark Physical Therapy, Inc CurrentSince Aug 26, 2024 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Aug 26, 2024 Accepting new patients
Institute of Physical Therapy and Fitness Physical Therapist PastSince Mar 7, 2025 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

590 441 Historic Hwy N
#E
Demorest, GA 30535
Phone (706) 754-6611

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

11490 Alpharetta Hwy
Ste 200
Roswell, GA 30076
Phone (770) 740-8592

6635 Roswell Rd
Sandy Springs, GA 30328
Phone (678) 332-2030

Organizations & group practices 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1723075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765152000000",
    "number": "1013748508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "866-518-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 441 HISTORIC HWY N STE E",
            "city": "DEMOREST",
            "state": "GA",
            "postal_code": "305354561",
            "telephone_number": "706-754-6611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILBANKS",
        "first_name": "CALVIN",
        "middle_name": "COLSTON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-08-08",
        "last_updated": "2025-12-08",
        "certification_date": "2025-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT017286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Demorest, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2025; 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.