Active NPI
PT Solutions of Acworth LLC
- Specialist
- Douglasville, GA
National Provider Identifier
1083895973
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Specialist
- Legal business name
- PT SOLUTIONS OF ACWORTH LLC
- Practice address
- 9390 The Landing Drive
Suite 201
Douglasville, GA 30135 - Phone
- (770) 852-1692
- Fax
- (770) 852-1694
- NPI assigned
- Nov 19, 2007
- Last updated
- Feb 11, 2010
- 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
- Dr. Dale Yake, PT
- Title
- Ceo
- Phone
- (770) 852-1692
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Specialist | 174400000X | NU | Primary |
Addresses
Primary practice location
9390 The Landing Drive
Suite 201
Douglasville, GA 30135
Mailing address
PO Box 242278
Montgomery, AL 36124-2278
Phone (334) 396-3273
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
Locations
9390 The Landing Dr
Ste 201
Douglasville, GA 30135
Phone (770) 852-1692
Practitioners & affiliated clinicians
Practitioners 1
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.
-
- Physical Therapist
- Acworth, GA
- NPI 1174573950
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1195430400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1265846400000",
"number": "1083895973",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 242278",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361242278",
"telephone_number": "334-396-3273",
"fax_number": "334-396-4905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9390 THE LANDING DRIVE",
"address_2": "SUITE 201",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "30135",
"telephone_number": "770-852-1692",
"fax_number": "770-852-1694"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PT SOLUTIONS OF ACWORTH LLC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "PT SOLUTIONS OF ACWORTH LLC",
"enumeration_date": "2007-11-19",
"last_updated": "2010-02-11",
"status": "A",
"authorized_official_last_name": "YAKE",
"authorized_official_first_name": "DALE",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "770-852-1692",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "PT"
},
"taxonomies": [
{
"code": "174400000X",
"taxonomy_group": "",
"desc": "Specialist",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglasville, GA
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- Eileen A Puterski, M.S.
- Amparo Pyronneau, NP
- Qualicare of Georgia, Inc
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2010; 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.