Individual provider Active NPI

Maria Concepcion Atienza Panganiban

  • Physical Therapist
  • McDonough, GA
National Provider Identifier
1033833892
Registry record updated Mar 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT016476 Issued in GA
Practice address
898 Hampton Rd
McDonough, GA 30253-6514
Phone
(678) 583-9954
Fax
(678) 583-8709
NPI assigned
Sep 26, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1289826 TX
Physical Therapist 225100000X PT016476 GA Primary

Addresses

Primary practice location

898 Hampton Rd
McDonough, GA 30253-6514

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230505001807 GA Practitioner - Physical Therapist in Private Practice 6204291784 Reassigns benefits to 4 organizations
Practice locations: Dallas, GA

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

898 Hampton Rd
McDonough, GA 30253-6514
Phone (678) 583-8709

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1289826TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Drayer Physical Therapy Georgia LLC Physical Therapist CurrentSince Mar 3, 2023 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Mar 3, 2023 Accepting new patients
Benchmark Physical Therapy, Inc CurrentSince Mar 3, 2023 Accepting new patients
Benchmark Physical Therapy, Inc CurrentSince Mar 3, 2023 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Mar 3, 2023 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist Current Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Mar 3, 2023 Accepting new patients
Independent Physical Therapy, LLC CurrentSince Mar 3, 2023 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

1441 Dresden Dr NE
Ste 290
Brookhaven, GA 30319
Phone (470) 575-4333

7951 Villa Rica Hwy
Ste 117
Dallas, GA 30157
Phone (470) 977-3310

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

3455 Highway 81
Loganville, GA 30052
Phone (678) 635-8280

5948 East Lake Pkwy
McDonough, GA 30253
Phone (470) 878-6059

898 Hampton Rd
McDonough, GA 30253
Phone (678) 583-9954

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679011200000",
    "number": "1033833892",
    "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": "898 HAMPTON RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302536514",
            "telephone_number": "678-583-9954",
            "fax_number": "678-583-8709"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PANGANIBAN",
        "first_name": "MARIA CONCEPCION",
        "middle_name": "ATIENZA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-26",
        "last_updated": "2023-03-17",
        "certification_date": "2023-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1289826",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT016476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2023; 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.