Active NPI
Janet Vollrath, RPT
- Physical Therapist
- Blue Ridge, GA
National Provider Identifier
1104987791
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT002423
- Practice address
- 259 Pony Ghost TRL
Blue Ridge, GA 30513-7550 - Phone
- (706) 632-4418
- Fax
- (706) 632-9756
- NPI assigned
- Dec 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT002423 | GA | Primary |
Addresses
Primary practice location
259 Pony Ghost TRL
Blue Ridge, GA 30513-7550
Mailing address
259 Pony Ghost TRL
Blue Ridge, GA 30513-7550
Phone (706) 632-4418
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00830893A | Medicaid | GA |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT002423 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1165968000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1104987791",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "259 PONY GHOST TRL",
"city": "BLUE RIDGE",
"state": "GA",
"postal_code": "305137550",
"telephone_number": "706-632-4418",
"fax_number": "706-632-9756"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "259 PONY GHOST TRL",
"city": "BLUE RIDGE",
"state": "GA",
"postal_code": "305137550",
"telephone_number": "706-632-4418",
"fax_number": "706-632-9756"
}
],
"practiceLocations": [],
"basic": {
"last_name": "VOLLRATH",
"first_name": "JANET",
"credential": "RPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-12-13",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT002423",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00830893A",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Blue Ridge, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.