Active NPI
PT Solutions of Acworth, LLC
- Physical Therapist
- Brookhaven, GA
National Provider Identifier
1083166565
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- PT SOLUTIONS OF ACWORTH, LLC
- Practice address
- 3575 Durden Dr NE Ste 304-a
Brookhaven, GA 30319-2253 - Phone
- (678) 831-7759
- Fax
- (678) 831-7779
- NPI assigned
- Oct 31, 2016
- Last updated
- Oct 31, 2016
- Organization subpart
- Yes
- Parent organization
- PT SOLUTIONS OF ACWORTH, LLC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Jennifer L Hall
- Title
- Chief Financial Officer
- Phone
- (770) 615-4856
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | NU | Primary |
Addresses
Primary practice location
3575 Durden Dr NE Ste 304-a
Brookhaven, GA 30319-2253
Mailing address
PO Box 441146
Kennesaw, GA 30160-9522
Phone (770) 917-1935
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040629000794 | GA | Part B Supplier - Clinic/Group Practice | 0042291817 |
Receives reassigned benefits from 14 practitioners 33 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Hahira, GA; Watkinsville, GA; Villa Rica, GA; Valdosta, GA; Tyrone, GA; Norcross, GA; Evans, GA; Decatur, GA… |
Other NPIs on the same Medicare enrollment 33
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider Directory- Part of
- PT Solutions of Acworth LLC
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1477872000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1477872000000",
"number": "1083166565",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 441146",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301609522",
"telephone_number": "770-917-1935"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3575 DURDEN DR NE STE 304-A",
"city": "BROOKHAVEN",
"state": "GA",
"postal_code": "303192253",
"telephone_number": "678-831-7759",
"fax_number": "678-831-7779"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PT SOLUTIONS OF ACWORTH, LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PT SOLUTIONS OF ACWORTH, LLC",
"enumeration_date": "2016-10-31",
"last_updated": "2016-10-31",
"status": "A",
"authorized_official_last_name": "HALL",
"authorized_official_first_name": "JENNIFER",
"authorized_official_middle_name": "L",
"authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
"authorized_official_telephone_number": "770-615-4856"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brookhaven, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; 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.