NPIMap

Organization Active NPI

Activekidz and Adult Therapy Services

  • Physical Therapist
  • Toccoa, GA
National Provider Identifier
1073983953
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
5588 Issued in GA
Legal business name
ACTIVEKIDZ AND ADULT THERAPY SERVICES
Practice address
348 Big a Rd
Toccoa, GA 30577
Phone
(770) 207-6390
NPI assigned
Oct 5, 2015
Last updated
Apr 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Authorized official

Name
Susan CookNPI 1295775955
Title
Owner
Phone
(770) 207-6390

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 5588 GA Primary

Addresses

Primary practice location

348 Big a Rd
Toccoa, GA 30577

Mailing address

1431 Capital Ave
Watkinsville, GA 30677-1883
Phone (770) 207-6390

Other identifiers 1

IdentifierTypeStateIssuer
000875102BMedicaidGA

National Provider Directory

National Provider Directory

Locations

1247 Tuscany Dr
Ste C
Braselton, GA 30517
Phone (678) 661-4545

1431 Capital Ave
Watkinsville, GA 30677

Practitioners & affiliated clinicians

Practitioners 46

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 46

NPI Registry JSON

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1073983953",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 CAPITAL AVE",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306771883",
            "telephone_number": "770-207-6390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "348 BIG A RD",
            "city": "TOCCOA",
            "state": "GA",
            "postal_code": "30577",
            "telephone_number": "770-207-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVEKIDZ AND ADULT THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-10-05",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-207-6390"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "5588",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000875102B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Toccoa, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.