Individual provider Active NPI

Stephanie Woodall, DPT

  • Physical Therapist
  • Athens, GA
National Provider Identifier
1124437355
Registry record updated Aug 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT011530 Issued in GA
Practice address
665 Gaines School Rd
Athens, GA 30605-3127
Phone
(706) 369-8115
NPI assigned
Aug 13, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT011530 GA Primary

Addresses

Primary practice location

665 Gaines School Rd
Athens, GA 30605-3127

Mailing address

665 Gaines School Rd
Athens, GA 30605-3127
Phone (706) 369-8115

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141120001399 GA Practitioner - Physical Therapist in Private Practice 8820210131 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Medical College of Georgia School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
East Athens Physical Therapy, IncGroup PAC ID 8224025499, 6 clinicians

Practice addresses (Care Compare)

30 Tim TRL
Danielsville, GA 30633-6929
Phone (706) 795-0155

Merit-based Incentive Payment System (MIPS)

Final score
52.52 of 100Reported as group
Quality
0
Improvement activities
40
Cost
75.06

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT011530GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
East Athens Physical Therapy Inc CurrentSince Feb 2, 2022 Accepting new patients

Locations

665 Gaines School Rd
Athens, GA 30605
Phone (706) 369-8115

30 Tim Trl
Danielsville, GA 30633
Phone (706) 795-0155

1541 Old Buckhead Rd
Madison, GA 30650
Phone (703) 342-0336

Organizations & group practices 1

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": "1407888000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407888000000",
    "number": "1124437355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 GAINES SCHOOL RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306053127",
            "telephone_number": "706-369-8115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "665 GAINES SCHOOL RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306053127",
            "telephone_number": "706-369-8115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODALL",
        "first_name": "STEPHANIE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-13",
        "last_updated": "2014-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011530",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2014; 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.