Active NPI
PT Solutions of Acworth LLC
- Physical Therapist
- Conyers, GA
National Provider Identifier
1093379893
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- PT SOLUTIONS OF ACWORTH LLC
- Practice address
- 1380 Milstead Ave NE Ste C
Conyers, GA 30012-3864 - Phone
- (470) 474-1490
- NPI assigned
- Apr 26, 2019
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Carmen Philpot
- Title
- Revenue Cycle Director
- Phone
- (678) 403-3568
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary | ||
| Occupational Therapist | 225X00000X |
Addresses
Primary practice location
1380 Milstead Ave NE Ste C
Conyers, GA 30012-3864
Mailing address
1100 Circle 75 Pkwy SE Ste 1400
Atlanta, GA 30339-3067
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 DirectoryMember of 1
Organizations this organization is a member of, according to the National Provider Directory.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556236800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1556236800000",
"number": "1093379893",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1100 CIRCLE 75 PKWY SE STE 1400",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303393067"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1380 MILSTEAD AVE NE STE C",
"city": "CONYERS",
"state": "GA",
"postal_code": "300123864",
"telephone_number": "470-474-1490"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PT SOLUTIONS OF ACWORTH LLC",
"organizational_subpart": "NO",
"enumeration_date": "2019-04-26",
"last_updated": "2019-04-26",
"status": "A",
"authorized_official_last_name": "PHILPOT",
"authorized_official_first_name": "CARMEN",
"authorized_official_title_or_position": "REVENUE CYCLE DIRECTOR",
"authorized_official_telephone_number": "678-403-3568"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
},
{
"code": "225X00000X",
"taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Conyers, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; 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.