Mirmon Troi Virgino De Vera, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT017580 Issued in GA

Practice address

6050 Peachtree Pkwy Ste 410
Norcross, GA 30092-3337

Phone

(770) 441-1276

NPI assigned

May 30, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians

Emory Physical Therapy, LLCGroup PAC ID 1153382676, 96 clinicians

Independent Physical Therapy of Georgia, LLCGroup PAC ID 2961312244, 526 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Emory Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Atlanta, GA
  • NPI 1922018423
  Medicare reassignment Care Compare group NPD
• Independent Physical Therapy of Georgia, LLC

  • Physical Therapist
  • Fort Oglethorpe, GA
  • NPI 1780636068
  Medicare reassignment Care Compare group NPD
• Agilitas USA Inc

  • Physical Therapy Clinic/Center
  • Hixson, TN
  • NPI 1962417444

  GA, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Benchmark Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Duluth, GA
  • NPI 1083666903
  Medicare reassignment NPD
• Georgia Luna Care Physical Therapy LLC

  • Physical Therapist
  • Atlanta, GA
  • NPI 1245826999
  Medicare reassignment NPD
• Atlanta South Physical Therapy, Inc

  • Physical Therapist
  • Lawrenceville, GA
  • NPI 1922051564
  NPD
• Emory Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Lithonia, GA
  • NPI 1346119831
  NPD
• Emory Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Brookhaven, GA
  • NPI 1720097561
  NPD
• Independent Physical Therapy of Georgia, LLC

  • Occupational Therapist
  • Gainesville, GA
  • NPI 1306013941

  Physical Therapist

  NPD
• Agilitas USA, Inc

  • Physical Therapy Clinic/Center
  • Chattanooga, TN
  • NPI 1518695436

  Physical Therapist

  NPD

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1738022400000",
    "number": "1073353546",
    "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": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6050 PEACHTREE PKWY STE 410",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300923337",
            "telephone_number": "770-441-1276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1580 Sawgrass Corporate Pkwy",
            "address_purpose": "LOCATION",
            "city": "Sunrise",
            "state": "FL",
            "postal_code": "333232859",
            "country_code": "US",
            "telephone_number": "954-739-4247",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DE VERA",
        "first_name": "MIRMON TROI",
        "middle_name": "VIRGINO",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-30",
        "last_updated": "2025-01-28",
        "certification_date": "2025-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CT",
            "license": "12068",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT017580",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie Kay Davis, M.S., CCC-SLP
• Tahjane Davis
• Crystal Davy
• Boris McGuire Day
• Juliana De Jesus Ferreira Alves, PT, MS
• Joanie D Dean
• Suzanne Kae Decann
• Dekalb-Gwinnett OB/GYN PC
• Marcelo Delaserna, PH.D.
• Norberto N Delgado, DDS

• Physical Therapist in Norcross, GA
• Providers in Norcross, 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 28, 2025; 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.