Jose Roberto Aveiga, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT014220 Issued in GA

Practice address

1227 Rockbridge Rd Ste 402
Stone Mountain, GA 30087-3006

Phone

(770) 925-9210

Fax

(770) 925-7989

NPI assigned

Aug 8, 2019

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Independent Physical Therapy, LLC

  • Physical Therapist
  • Stone Mountain, GA
  • NPI 1447654058
  NPD (past)

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

{
    "created_epoch": "1565222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565222400000",
    "number": "1104471812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214915",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 ROCKBRIDGE RD STE 402",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873006",
            "telephone_number": "770-925-9210",
            "fax_number": "770-925-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVEIGA",
        "first_name": "JOSE",
        "middle_name": "ROBERTO",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-08-08",
        "last_updated": "2019-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014220",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Atlanta Metro Psychiatric Associates
• Atlanta Mobile Medical LLC
• Atlanta Podiatry Clinic
• Michele Ellen Audet, PT
• Corliss La-Shunuette Austin-Harris, D.P.M., M.S.
• Franky Azor, LPN
• B and B Orthopedics and Spine LLC
• George Foster Baker Jr.
• Malissa Abena Baker
• Balanced Care, LLC

• All providers in Stone Mountain, GA
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2019; 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.