Robert Canecchio III, P.T., D.P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT010444 Issued in GA

Practice address

11660 Alpharetta Hwy Ste 640
Roswell, GA 30076-3891

Phone

(678) 624-9112

Fax

(678) 624-0747

NPI assigned

Sep 27, 2011

Sex

Male

Sole proprietor

No

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 GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2011

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Immanuels Word IncGroup PAC ID 5395785620, 2 clinicians

Practice addresses (Care Compare)

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.

• Immanuels Word Inc

  • Physical Therapy Clinic/Center
  • Alpharetta, GA
  • NPI 1912949322
  Medicare reassignment Care Compare group NPD
• RC3 PT

  • Physical Therapy Clinic/Center
  • Roswell, GA
  • NPI 1336837921
  NPD Authorized official

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

{
    "created_epoch": "1317081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681084800000",
    "number": "1124301031",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11660 ALPHARETTA HWY STE 640",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300763891",
            "telephone_number": "678-624-9112",
            "fax_number": "678-624-0747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11660 ALPHARETTA HWY STE 640",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300763891",
            "telephone_number": "678-624-9112",
            "fax_number": "678-624-0747"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CANECCHIO",
        "first_name": "ROBERT",
        "name_prefix": "Dr.",
        "name_suffix": "III",
        "credential": "P.T., D.P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-09-27",
        "last_updated": "2023-04-10",
        "certification_date": "2023-04-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT010444",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Campbell Wray Consulting
• Ashlianne Campbell
• Earl Vendryes Campbell III, M.D.
• Emelda Shurrell Campbell
• Tonya Lynn Campbell, CRNA
• Michael Canfarotta, MD
• Jennifer Lynn Cano, RN, BSN,IBCLC
• Christine Cantilena Barnes, LPC, NCC, MS, CPCS
• Cindy Hoang Cao, PHARMD
• Cap Atl 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 Apr 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.