Dekalbphysical Therapy

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

295 Issued in GA

Legal business name

DEKALBPHYSICAL THERAPY

Practice address

5462 Memorial Dr
Suite 203
Stone MTN, GA 30083-3239

Phone

(770) 491-1353

Fax

(770) 723-9653

NPI assigned

Apr 19, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Robert L. McNeilNPI 1558588608

Title

Physical Therapist

Phone

(404) 297-9330

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Robert L. McNeil, P.T.

  • Physical Therapist
  • Stone MTN, GA
  • NPI 1558588608
  NPD (past) Authorized official
• Yvonne M McNeil, SLP

  • Speech-Language Pathologist
  • Stone MTN, GA
  • NPI 1124245113
  NPD (past)

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1124245295",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5462 MEMORIAL DR",
            "address_2": "SUITE 203",
            "city": "STONE MTN",
            "state": "GA",
            "postal_code": "300833239",
            "telephone_number": "770-491-1353",
            "fax_number": "404-297-9329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5462 MEMORIAL DR",
            "address_2": "SUITE 203",
            "city": "STONE MTN",
            "state": "GA",
            "postal_code": "300833239",
            "telephone_number": "770-491-1353",
            "fax_number": "770-723-9653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEKALBPHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-19",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MCNEIL",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "404-297-9330",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "295",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Dept. of Veterans Affairs
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• First Choice Medical Equipment
• Jerream C Flowers
• Goshen Applied Behavior Analysis (ABA), Inc

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.