Individual provider Active NPI

Burton William Stevens Jr., DPT, SCS, ATC

  • Physical Therapist
  • Woodstock, GA
National Provider Identifier
1093746638
Registry record updated Mar 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT009114 Issued in GA
Practice address
6884 Hickory Flat Hwy
Woodstock, GA 30188-3229
Phone
(770) 704-8244
Fax
(770) 704-8264
NPI assigned
Jul 5, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2016

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 PT17884 FL
Physical Therapist 225100000X PT009114 GA Primary

Addresses

Primary practice location

6884 Hickory Flat Hwy
Woodstock, GA 30188-3229

Mailing address

6884 Hickory Flat Hwy
Woodstock, GA 30188-3229
Phone (770) 704-8244

Other identifiers 1

IdentifierTypeStateIssuer
511I650340OtherGAMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090223000323 GA Practitioner - Physical Therapist in Private Practice 5395800551 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Soar Physical Therapy, IncGroup PAC ID 0941365100, 18 clinicians

Practice addresses (Care Compare)

6884 Hickory Flat Hwy
Woodstock, GA 30188-3229
Phone (770) 704-8244

Merit-based Incentive Payment System (MIPS)

Final score
86.79 of 100Reported as group
Quality
82.48
Improvement activities
40
Cost
79.32

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT17884FLMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Soar Physical Therapy, Inc CurrentSince Jun 18, 2008 Accepting new patients
Hornsby Rehabilitation Services LLC Physical Therapist PastSince Nov 16, 1992 Accepting new patients

Locations

3342 Trickum Rd
Ste D
Woodstock, GA 30188
Phone (678) 401-5772

6884 Hickory Flat Hwy
Woodstock, GA 30188
Phone (770) 704-8244

Networks

  • Freedom Health HMO Network

Organizations & group practices 2

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": "1152057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1458259200000",
    "number": "1093746638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6884 HICKORY FLAT HWY",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883229",
            "telephone_number": "770-704-8244",
            "fax_number": "770-704-8264"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6884 HICKORY FLAT HWY",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301883229",
            "telephone_number": "770-704-8244",
            "fax_number": "770-704-8264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STEVENS",
        "first_name": "BURTON",
        "middle_name": "WILLIAM",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "DPT, SCS, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-05",
        "last_updated": "2016-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT17884",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT009114",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "511I650340",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2016; 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.