NPIMap

Organization Active NPI

Pediatric Thera Pea Services of Georgia, LLC

  • Pediatric Physical Therapist
  • Dahlonega, GA
National Provider Identifier
1083204275
Registry record updated Apr 13, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
Legal business name
PEDIATRIC THERA PEA SERVICES OF GEORGIA, LLC
Practice address
670 Arrendale Rd
Dahlonega, GA 30533-5128
Phone
(706) 344-9316
NPI assigned
Jan 21, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2022

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

Authorized official

Name
Dr. Haley While, DPT
Title
Owner
Phone
(706) 344-9316

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 2251P0200X Primary

Addresses

Primary practice location

670 Arrendale Rd
Dahlonega, GA 30533-5128

Mailing address

670 Arrendale Rd
Dahlonega, GA 30533-5128

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1611187200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649808000000",
    "number": "1083204275",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "670 ARRENDALE RD",
            "city": "DAHLONEGA",
            "state": "GA",
            "postal_code": "305335128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 ARRENDALE RD",
            "city": "DAHLONEGA",
            "state": "GA",
            "postal_code": "305335128",
            "telephone_number": "706-344-9316"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEDIATRIC THERA PEA SERVICES OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-01-21",
        "last_updated": "2022-04-13",
        "certification_date": "2022-04-13",
        "status": "A",
        "authorized_official_last_name": "WHILE",
        "authorized_official_first_name": "HALEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-344-9316",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dahlonega, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2022; 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.