Active NPI
Laura Brennan O'Lannerghty, PT, DPT
- Physical Therapist
- Leesburg, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 293274
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 293274 | Other | CA | PHYSICAL THERAPY BOARD OF CALIFORNIA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| 293274 | CA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Flint River Physical Therapy LLC | Physical Therapist | Current | 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.
-
- Physical Therapy Clinic/Center
- Camilla, GA
- NPI 1164491015
Physical Therapist
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.