Mark Raymond Westra, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2118 Issued in GA

Practice address

1610 John Orr Dr
Tifton, GA 31794-3682

Phone

(229) 391-4580

Fax

(229) 391-4585

NPI assigned

Jan 3, 2013

Last updated

Jan 3, 2013By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Georgia Sports Medicine and Orthopedic Clinic, PC

  • Orthopaedic Surgery Physician
  • Tifton, GA
  • NPI 1023217171
  NPD (past)

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

{
    "created_epoch": "1357171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1357171200000",
    "number": "1063758597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 US HIGHWAY 19 N",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317198300",
            "telephone_number": "229-938-8072",
            "fax_number": "229-391-4585"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1610 JOHN ORR DR",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317943682",
            "telephone_number": "229-391-4580",
            "fax_number": "229-391-4585"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WESTRA",
        "first_name": "MARK",
        "middle_name": "RAYMOND",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-01-03",
        "last_updated": "2013-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "2118",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Judy E Weaver, APRNBC
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• Arita Wheeler
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• Wholistic Therapeutic Services

• Physical Therapist in Tifton, GA
• Providers in Tifton, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2013; 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.