Individual provider Active NPI

Priyanka Gorukanti

  • Physical Therapist
  • Fayetteville, GA
National Provider Identifier
1083470868
Registry record updated Oct 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP048435T Issued in GA
Practice address
1275 Highway 54 W Ste 200
Fayetteville, GA 30214-4538
Phone
(770) 460-8609
NPI assigned
Feb 28, 2024
Last updated
Oct 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 21, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 049032 NY
Physical Therapist 225100000X CP048435T GA Primary

Addresses

Primary practice location

1275 Highway 54 W Ste 200
Fayetteville, GA 30214-4538

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Other practice location 1

2995 Ocean Pkwy # Bs
Brooklyn, NY 11235-8390
Phone (718) 373-0856

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20250123001482 TX Practitioner - Physical Therapist in Private Practice 9931546967 Reassigns benefits to 1 organization
I20251223004064 GA Practitioner - Physical Therapist in Private Practice 9931546967 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benchmark Physical Therapy, IncGroup PAC ID 1557395209, 69 clinicians

Practice addresses (Care Compare)

1275 Hwy 54 W 200
Fayetteville, GA 30214-4538
Phone (770) 460-8609

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
CP048435TGAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy, Inc CurrentSince Oct 20, 2025 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Oct 20, 2025 Accepting new patients
Benchmark Physical Therapy Inc Physical Therapist CurrentSince Oct 20, 2025 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Oct 20, 2025 Accepting new patients
Advance Therapy PC Physical Therapist CurrentSince Nov 18, 2024 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Oct 20, 2025 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Oct 20, 2025 Accepting new patients
Advance Therapy PC Physical Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

12850 Highway 9 N
Ste 1050
Alpharetta, GA 30004
Phone (678) 332-5800

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

1275 Highway 54 W
Ste 200
Fayetteville, GA 30214
Phone (770) 460-8609

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

400 Tower Rd NE
Ste 140
Marietta, GA 30060
Phone (770) 419-9437

11490 Alpharetta Hwy
Ste 200
Roswell, GA 30076
Phone (770) 740-8592

3700 Cross Park Dr
Bryan, TX 77802
Phone (979) 774-9958

415 W Wheatland Rd
#102
Duncanville, TX 75116
Phone (972) 296-1808

1110 Cottonwood Ln
Ste 100
Irving, TX 75038
Phone (972) 943-9779

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1709078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761004800000",
    "number": "1083470868",
    "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": "1275 HIGHWAY 54 W STE 200",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144538",
            "telephone_number": "770-460-8609"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2995 Ocean Pkwy # Bs",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112358390",
            "country_code": "US",
            "telephone_number": "718-373-0856",
            "fax_number": "718-373-2865",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GORUKANTI",
        "first_name": "PRIYANKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-28",
        "last_updated": "2025-10-21",
        "certification_date": "2025-10-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NY",
            "license": "049032",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "CP048435T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 21, 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.