NPIMap

Organization Active NPI

Benchmark Physical Therapy, Inc

  • Physical Therapist
  • Lawrenceville, GA
National Provider Identifier
1053564047
Registry record updated Feb 22, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
BENCHMARK PHYSICAL THERAPY, INC
Practice address
4825 Sugarloaf Pkwy Ste C
Lawrenceville, GA 30044-8800
Phone
(678) 985-0238
Fax
(678) 985-0136
NPI assigned
Nov 4, 2008
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Kevin Johanneson
Title
VP Revenue Cycle
Phone
(423) 238-7217

Other NPIs on the same Medicare enrollment 16

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Practitioners 8

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

Medicare participation

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

Medicare enrollment records 1

Medicare enrollment files
Enrollment IDStateProvider typePAC IDDetails
O20050921001120 GA Part B Supplier - Clinic/Group Practice 1557395209 Receives reassigned benefits from 760 practitioners
16 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Newnan, GA; Peachtree City, GA; Riverdale, GA; Snellville, GA; Stockbridge, GA; Cumming, GA; Jonesboro, GA; Fayetteville, GA…

National Provider Directory

National Provider Directory

Locations

4825 Sugarloaf Pkwy
Ste C
Lawrenceville, GA 30044
Phone (678) 583-9954

Specialties & licenses 3

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193200000X MULTI-SPECIALTY GROUP 235Z00000X

Addresses

NPPES NPI Registry

Primary practice location

4825 Sugarloaf Pkwy Ste C
Lawrenceville, GA 30044-8800

Mailing address

6397 Lee Hwy Ste 300
Chattanooga, TN 37421-2564
Phone (423) 238-7217

Other practice location 1

455 Philip Blvd
Building 100 Suite 160
Lawrenceville, GA 30045-8767
Phone (678) 985-0238

Other names 1

NPPES NPI Registry
  • Benchmark Other name

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Feb 22, 2019.

{
    "created_epoch": "1225756800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550793600000",
    "number": "1053564047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212564",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4825 SUGARLOAF PKWY STE C",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300448800",
            "telephone_number": "678-985-0238",
            "fax_number": "678-985-0136"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "455 Philip Blvd",
            "address_2": "Building 100 Suite 160",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300458767",
            "country_code": "US",
            "telephone_number": "678-985-0238",
            "fax_number": "678-985-0136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "BENCHMARK PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-04",
        "last_updated": "2019-02-22",
        "status": "A",
        "authorized_official_last_name": "JOHANNESON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "VP REVENUE CYCLE",
        "authorized_official_telephone_number": "423-238-7217"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Benchmark",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Benchmark",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Lawrenceville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 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.