Rudo Alice Takawira, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT012671 Issued in GA

Practice address

4595 Cantrell Rd
Flowery Branch, GA 30542-3304

Phone

(770) 967-2070

NPI assigned

Dec 11, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

May accept Medicare assignment

Group practices

Fox Rehabilitation Ga, LLCGroup PAC ID 6800162298, 109 clinicians

Practice addresses (Care Compare)

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.

• Fox Rehabilitation Ga, LLC

  • Physical Therapist
  • Atlanta, GA
  • NPI 1023544624
  Medicare reassignment Care Compare group
• Georgia Luna Care Physical Therapy LLC

  • Physical Therapist
  • Atlanta, GA
  • NPI 1245826999
  Medicare reassignment NPD

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

{
    "created_epoch": "1512950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616976000000",
    "number": "1104331206",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2376 BRANSLEY PL",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300974336",
            "telephone_number": "214-952-4605"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4595 CANTRELL RD",
            "city": "FLOWERY BRANCH",
            "state": "GA",
            "postal_code": "305423304",
            "telephone_number": "770-967-2070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TAKAWIRA",
        "first_name": "RUDO",
        "middle_name": "ALICE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-12-11",
        "last_updated": "2021-03-29",
        "certification_date": "2021-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "GA",
            "license": "PT012671",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012671",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Stone, D.C.
• Swaim Services, LLC
• Kati Swalwell
• Syah, LLC
• Taqualla Tait
• Tara Goetz Counseling
• Joseph B Taylor, PT,DPT
• The Crossroads of Flowery Branch of Journey LLC
• The Kroger Co
• The Kroger Co

• Physical Therapist in Flowery Branch, GA
• Providers in Flowery Branch, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2021; 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.