Organization Active NPI

Smyrna Medical and Physical Therapy, LLC

  • Physical Medicine & Rehabilitation Physician
  • Smyrna, GA
National Provider Identifier
1033396320
Registry record updated Jan 29, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
SMYRNA MEDICAL AND PHYSICAL THERAPY, LLC
Practice address
3330 S Cobb Dr SE
Suite B
Smyrna, GA 30080-4118
Phone
(770) 444-0211
Fax
(770) 444-0079
NPI assigned
Jan 29, 2008
Last updated
Jan 29, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2008

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

Authorized official

Name
Carl T Shenkman
Title
Medical Director
Phone
(770) 444-0211

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X Primary

Addresses

Primary practice location

3330 S Cobb Dr SE
Suite B
Smyrna, GA 30080-4118

Mailing address

3330 S Cobb Dr SE
Suite B
Smyrna, GA 30080-4118
Phone (770) 444-0211

National Provider Directory

National Provider Directory

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1201564800000",
    "number": "1033396320",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3330 S COBB DR SE",
            "address_2": "SUITE B",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300804118",
            "telephone_number": "770-444-0211",
            "fax_number": "770-444-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 S COBB DR SE",
            "address_2": "SUITE B",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300804118",
            "telephone_number": "770-444-0211",
            "fax_number": "770-444-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SMYRNA MEDICAL AND PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-29",
        "last_updated": "2008-01-29",
        "status": "A",
        "authorized_official_last_name": "SHENKMAN",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "MEDICAL  DIRECTOR",
        "authorized_official_telephone_number": "770-444-0211"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Smyrna, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2008; 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.