NPIMap

Organization Active NPI

Magnolia Physical Therapy and Wellness

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1023523966
Registry record updated Dec 13, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT009742 Issued in GA
Legal business name
MAGNOLIA PHYSICAL THERAPY AND WELLNESS
Practice address
420 Elden Dr
Atlanta, GA 30342-2034
Phone
(575) 993-8428
NPI assigned
Dec 13, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 13, 2017

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

Authorized official

Name
Anna Stromquist, PT, DPTNPI 1922306745
Title
Owner
Phone
(575) 993-8428

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X PT009742 GA Primary

Addresses

Primary practice location

420 Elden Dr
Atlanta, GA 30342-2034

Mailing address

420 Elden Dr
Atlanta, GA 30342-2034

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180908000027 GA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5496005639 Receives reassigned benefits from 5 practitioners
Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1513123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1513123200000",
    "number": "1023523966",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "420 ELDEN DR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303422034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "420 ELDEN DR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303422034",
            "telephone_number": "575-993-8428"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAGNOLIA PHYSICAL THERAPY AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-13",
        "last_updated": "2017-12-13",
        "status": "A",
        "authorized_official_last_name": "STROMQUIST",
        "authorized_official_first_name": "ANNA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "575-993-8428",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT009742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2017; 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.