Individual provider Active NPI

Khoi Nguyen, DPT

  • Physical Therapist
  • Marietta, GA
National Provider Identifier
1023628369
Registry record updated Jan 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT014752 Issued in GA
Practice address
1000 Johnson Ferry Rd Ste A115
Marietta, GA 30068-2110
Phone
(404) 367-2085
Fax
(770) 579-7060
NPI assigned
Aug 2, 2020
Last updated
Jan 21, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2021

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 PT014752 GA Primary

Addresses

Primary practice location

1000 Johnson Ferry Rd Ste A115
Marietta, GA 30068-2110

Mailing address

PO Box 949
Rome, GA 30162-0949
Phone (404) 367-2085

Other practice location 1

2484 Briarcliff Rd NE Ste 30
Atlanta, GA 30329-3011
Phone (404) 228-3678

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200922001262 GA Practitioner - Physical Therapist in Private Practice 9133547276 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT014752GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy, Inc CurrentSince Aug 25, 2020 Accepting new patients
Advance Rehabilitation & Consulting Limited Partnership Physical Therapist CurrentSince Feb 19, 2021 Accepting new patients
Advance Rehabilitation & Consulting Limited Partnership Physical Therapist CurrentSince Feb 19, 2021 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Aug 3, 2020 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Aug 3, 2020 Accepting new patients
Atlanta South Physical Therapy, Inc Physical Therapist CurrentSince Aug 25, 2020 Accepting new patients
Independent Physical Therapy of Ga LLC Physical Therapist PastSince Aug 1, 2020 Accepting new patients

Locations

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

2484 Briarcliff Rd NE
Ste 30
Atlanta, GA 30329
Phone (404) 228-3678

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

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

1000 Johnson Ferry Rd
Ste A115
Marietta, GA 30068
Phone (404) 367-2085

Organizations & group practices 7

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1596326400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611187200000",
    "number": "1023628369",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 949",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301620949",
            "telephone_number": "404-367-2085",
            "fax_number": "770-579-7060"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 JOHNSON FERRY RD STE A115",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300682110",
            "telephone_number": "404-367-2085",
            "fax_number": "770-579-7060"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2484 Briarcliff Rd NE Ste 30",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303293011",
            "country_code": "US",
            "telephone_number": "404-228-3678",
            "fax_number": "678-705-3560",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NGUYEN",
        "first_name": "KHOI",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-08-02",
        "last_updated": "2021-01-21",
        "certification_date": "2021-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014752",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2021; 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.