Individual provider Active NPI

Toniya Marie Farmer, DPT

  • Physical Therapist
  • Fayetteville, GA
National Provider Identifier
1104121136
Registry record updated May 17, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT010178 Issued in GA
Practice address
355 Brandywine Blvd
Fayetteville, GA 30214-1564
Phone
(678) 417-4672
NPI assigned
Jan 23, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 17, 2016

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 PT010178 GA Primary

Addresses

Primary practice location

355 Brandywine Blvd
Fayetteville, GA 30214-1564

Mailing address

355 Brandywine Blvd
Fayetteville, GA 30214-1564

Other identifiers 1

IdentifierTypeStateIssuer
GP2532MedicaidSC

Other names 1

  • Dr. Toniya Marie Brewer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Life Clinic of Ga PC Physical Therapist PastSince Dec 3, 2022 Accepting new patients

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": "1295740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1104121136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "355 BRANDYWINE BLVD",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "355 BRANDYWINE BLVD",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302141564",
            "telephone_number": "678-417-4672"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FARMER",
        "first_name": "TONIYA",
        "middle_name": "MARIE",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-01-23",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT010178",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "GP2532",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TONIYA",
            "last_name": "BREWER",
            "middle_name": "MARIE",
            "prefix": "DR.",
            "credential": "DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.