Individual provider Active NPI

Laura Brennan O'Lannerghty, PT, DPT

  • Physical Therapist
  • Leesburg, GA
National Provider Identifier
1093239477
Registry record updated Feb 9, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
293274 Issued in CA
Practice address
1366 US Highway 82 W
Leesburg, GA 31763-5810
Phone
(229) 883-4009
Fax
(229) 883-4320
NPI assigned
Jul 27, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 293274 CA Primary

Addresses

Primary practice location

1366 US Highway 82 W
Leesburg, GA 31763-5810

Mailing address

9070 W Cheyenne Ave Ste 100
Las Vegas, NV 89129-8935
Phone (615) 498-2288

Other practice location 1

130 E Broad St
Camilla, GA 31730-1809
Phone (229) 336-1115

Other identifiers 1

IdentifierTypeStateIssuer
293274OtherCAPHYSICAL THERAPY BOARD OF CALIFORNIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240509001430 GA Practitioner - Physical Therapist in Private Practice 5193099646 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Saint Louis University School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Flint River Physical Therapy. LLCGroup PAC ID 9234038662, 5 clinicians

Practice addresses (Care Compare)

130 E Broad St
Camilla, GA 31730-1809
Phone (229) 336-1115

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
293274CAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Flint River Physical Therapy LLC Physical Therapist CurrentSince Apr 4, 2024 Accepting new patients

Locations

130 E Broad St
Camilla, GA 31730
Phone (229) 336-1115

1366 US Highway 82 W
Leesburg, GA 31763
Phone (229) 883-4009

9070 W Cheyenne Ave
Ste 100
Las Vegas, NV 89129
Phone (702) 268-7213

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1501113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707436800000",
    "number": "1093239477",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9070 W CHEYENNE AVE STE 100",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "891298935",
            "telephone_number": "615-498-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1366 US HIGHWAY 82 W",
            "city": "LEESBURG",
            "state": "GA",
            "postal_code": "317635810",
            "telephone_number": "229-883-4009",
            "fax_number": "229-883-4320"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "130 E Broad St",
            "address_purpose": "LOCATION",
            "city": "Camilla",
            "state": "GA",
            "postal_code": "317301809",
            "country_code": "US",
            "telephone_number": "229-336-1115",
            "fax_number": "229-336-1151",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "O'LANNERGHTY",
        "first_name": "LAURA",
        "middle_name": "BRENNAN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-07-27",
        "last_updated": "2024-02-09",
        "certification_date": "2024-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "293274",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPY BOARD OF CALIFORNIA",
            "identifier": "293274",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Leesburg, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 2024; 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.