Roger Alan Kilcrease, P.T.

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

5456 Issued in GA

Practice address

2191 Northlake Pkwy
Suite 31
Tucker, GA 30084-4166

Phone

(770) 491-6004

Fax

(770) 723-0872

NPI assigned

Oct 4, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Atlanta Back Clinic - Orthopedic Phys Therapy & Training Ctr Inc

  dba Atlanta Back Clinic Inc

  • Physical Therapist
  • Tucker, GA
  • NPI 1467676924
  Medicare reassignment NPD

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191456000000",
    "number": "1104014125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2191 NORTHLAKE PKWY",
            "address_2": "SUITE 31",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844166",
            "telephone_number": "770-491-6004",
            "fax_number": "770-723-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2191 NORTHLAKE PKWY",
            "address_2": "SUITE 31",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844166",
            "telephone_number": "770-491-6004",
            "fax_number": "770-723-0872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILCREASE",
        "first_name": "ROGER",
        "middle_name": "ALAN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-04",
        "last_updated": "2007-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "GA",
            "license": "5456",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Caleb Elijah Keran, DC
• Jane M Kerner-Mendoza, CNS
• Kelly Keyser, LPC
• Sohaib A. Khalid, MD
• Kids & Teens Primary Health Care of Atlanta, P.C.
• Robert Andrew Killough, P.A.-C
• Sarah W Kilpatrick, RDN, LD, CDE, CCP
• Christin Kim, NP
• James Yon Kim, DMD
• Joo-Won Kim, DDS

• Orthopedic Physical Therapist in Tucker, GA
• Providers in Tucker, GA by specialty
• Orthopedic Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; 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.

Verify at the official NPI Registry.