Henry Iraheta

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT016262 Issued in GA

Practice address

12050 Etris Rd Ste E150
Roswell, GA 30075-8022

Phone

(770) 801-4657

NPI assigned

Sep 15, 2022

Sex

Male

Sole proprietor

Yes

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

Enrolled in FL

Enrollment records 1

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.

• Premier Rehab Management, LLC

  • Physical Therapist
  • Navarre, FL
  • NPI 1821014390
  Medicare reassignment NPD
• PT Solutions of Pensacola, LLC

  • Physical Therapist
  • Pensacola, FL
  • NPI 1730439092
  Medicare reassignment NPD
• Premier Rehab Management, LLC

  • Physical Therapist
  • Panama City Beach, FL
  • NPI 1700219599
  NPD
• PT Solutions of Pensacola LLC

  • Physical Therapist
  • Palm Coast, FL
  • NPI 1417517350
  NPD

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

{
    "created_epoch": "1663200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663200000000",
    "number": "1114649258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 CHARLES ST",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208501510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12050 ETRIS RD STE E150",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300758022",
            "telephone_number": "770-801-4657"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IRAHETA",
        "first_name": "HENRY",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-09-15",
        "last_updated": "2022-09-15",
        "certification_date": "2022-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT016262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Integrative Cap Health Practices
• Integrative Cap Health Practices
• Intermed Home Care Incorporated
• Interventional Spine and Pain Management Center, PC
• Lauren Beverly Ionta
• Janikha Isaacs, MA, CCC-SLP
• Ismile LLC
• Nedyalko Nedyalkov Ivanov, DO
• Colby Ives, RBT
• Ivey Neuromuscular LLC

• Physical Therapist in Roswell, GA
• Providers in Roswell, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.