Individual provider Active NPI

Erik Brandon Meeker, PT, DPT

  • Physical Therapist
  • Johns Creek, GA
National Provider Identifier
1063966083
Registry record updated Oct 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT012510 Issued in GA
Practice address
11720 Medlock Bridge Rd Ste 550
Johns Creek, GA 30097-2505
Phone
(678) 364-7195
Fax
(678) 681-9034
NPI assigned
Aug 8, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 9, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT012510 GA Primary

Addresses

Primary practice location

11720 Medlock Bridge Rd Ste 550
Johns Creek, GA 30097-2505

Mailing address

PO Box 306393
Nashville, TN 37230-6393
Phone (615) 373-1350

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190509000558 GA Practitioner - Physical Therapist in Private Practice 9032475744 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Mercer University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians

Practice addresses (Care Compare)

6635 Roswell Rd
Atlanta, GA 30328-3103
Phone (678) 332-2030

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT012510GAMDPhysical Therapist

Organizations & group practices 1

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": "1470614400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602201600000",
    "number": "1063966083",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306393",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306393",
            "telephone_number": "615-373-1350",
            "fax_number": "615-221-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11720 MEDLOCK BRIDGE RD STE 550",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300972505",
            "telephone_number": "678-364-7195",
            "fax_number": "678-681-9034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEEKER",
        "first_name": "ERIK",
        "middle_name": "BRANDON",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-08",
        "last_updated": "2020-10-09",
        "certification_date": "2020-10-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012510",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2020; 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.