Body G O a L S Physical Therapy & Wellness

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

BODY G O A L S PHYSICAL THERAPY & WELLNESS

Practice address

875 Old Roswell Rd Ste F100
Roswell, GA 30076-1658

Phone

(678) 871-6827

NPI assigned

Nov 17, 2017

Organization subpart

No

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

Authorized official

Name

Quiana T Fluellen, DPT, CERT. DNNPI 1518209584

Title

Ceo/Owner/DPT

Phone

(678) 298-9484

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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

• Quiana T Fluellen, PT

  • Physical Therapist
  • Kennesaw, GA
  • NPI 1518209584
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1510876800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1547164800000",
    "number": "1033623673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "875 OLD ROSWELL RD STE F100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761658",
            "telephone_number": "678-871-6827"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 OLD ROSWELL RD STE F100",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300761658",
            "telephone_number": "678-871-6827"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 Rigby Ct",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "GA",
            "postal_code": "300972488",
            "country_code": "US",
            "telephone_number": "352-284-0365",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BODY G O A L S PHYSICAL THERAPY & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-11-17",
        "last_updated": "2019-01-11",
        "status": "A",
        "authorized_official_last_name": "FLUELLEN",
        "authorized_official_first_name": "QUIANA",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO/OWNER/DPT",
        "authorized_official_telephone_number": "678-298-9484",
        "authorized_official_credential": "DPT, CERT. DN"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Priti Shah Bloor, DDS
• Blue Line Medical Products, LLC
• Blue Summit Hospice and Palliative Care of Roswell LLC
• Blue Summit Palliative Care LLC
• Kimberlyn Boddie, RBT
• Jessica Ginn Boehm, M.S. CCC-SLP
• Barbara Ann Bogartz, LPC
• Xander Boggs
• Mariana Bohn
• Scott Boice

• Physical Therapy Clinic/Center in Roswell, GA
• Providers in Roswell, GA by specialty
• Physical Therapy Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; 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.