NPIMap

Individual provider Active NPI

Cynthia Lyn Goldberg, P.T., A.T., C

  • Physical Therapist
  • Acworth, GA
National Provider Identifier
1114136157
Registry record updated Apr 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT2071 Issued in GA
Practice address
1311 Benbrooke LN NW
Acworth, GA 30101-8492
Phone
(678) 358-4328
Fax
(267) 321-2546
NPI assigned
May 22, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 20, 2011

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT2071 GA Primary
Orthopedic Physical Therapist 2251X0800X 2071 GA
Athletic Trainer 2255A2300X 75 GA

Addresses

Primary practice location

1311 Benbrooke LN NW
Acworth, GA 30101-8492

Mailing address

1311 Benbrooke LN NW
Acworth, GA 30101-8492
Phone (678) 358-4328

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

State licenses

LicenseStateTypeSpecialty
PT2071GAMDPhysical Therapist
75GAMDAthletic Trainer
2071GAMDAnesthesiologist Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Colorado, LLC PastSince Aug 22, 2014 Accepting new patients
Swanson Orthotics & Prosthetics Center, Inc. PastSince Jul 1, 2014 Accepting new patients
Central Iowa Physio, LLC PastSince Aug 1, 2015 Accepting new patients
Physiotherapy Associates Inc PastSince Jul 7, 2014 Accepting new patients
Matrix Rehabilitation Ohio, Inc. PastSince Jul 7, 2014 Accepting new patients

Organizations & group practices 5

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": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303257600000",
    "number": "1114136157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1311 BENBROOKE LN NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301018492",
            "telephone_number": "678-358-4328",
            "fax_number": "267-321-2546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1311 BENBROOKE LN NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301018492",
            "telephone_number": "678-358-4328",
            "fax_number": "267-321-2546"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOLDBERG",
        "first_name": "CYNTHIA",
        "middle_name": "LYN",
        "name_prefix": "Mrs.",
        "credential": "P.T., A.T., C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-22",
        "last_updated": "2011-04-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT2071",
            "primary": true
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "GA",
            "license": "2071",
            "primary": false
        },
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "75",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2011; 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.