NPIMap

Organization Active NPI

Sunshine Pediatric Therapy, LLC

  • Pediatric Physical Therapist
  • Dunwoody, GA
National Provider Identifier
1114297751
Registry record updated Apr 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
Legal business name
SUNSHINE PEDIATRIC THERAPY, LLC
Practice address
2347 Brookhurst Dr
Dunwoody, GA 30338-6631
Phone
(706) 540-3952
Fax
(404) 596-5433
NPI assigned
Jan 11, 2012
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 6, 2023

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

Authorized official

Name
Kathryn Roberson, PT, DPT
Title
Ceo
Phone
(706) 540-3952

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X Primary

Addresses

Primary practice location

2347 Brookhurst Dr
Dunwoody, GA 30338-6631

Mailing address

2347 Brookhurst Dr
Dunwoody, GA 30338-6631
Phone (770) 715-7067

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1326240000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1680739200000",
    "number": "1114297751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2347 BROOKHURST DR",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303386631",
            "telephone_number": "770-715-7067",
            "fax_number": "404-596-5433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2347 BROOKHURST DR",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303386631",
            "telephone_number": "706-540-3952",
            "fax_number": "404-596-5433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNSHINE PEDIATRIC THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-11",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A",
        "authorized_official_last_name": "ROBERSON",
        "authorized_official_first_name": "KATHRYN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "706-540-3952",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunwoody, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; 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.