Individual provider Active NPI

Joshua Young Davis, DPT

  • Physical Therapist
  • Lagrange, GA
National Provider Identifier
1134322100
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT008588 Issued in GA
Practice address
1514 Vernon Rd
Lagrange, GA 30240-4131
Phone
(706) 845-3677
Fax
(706) 845-3700
NPI assigned
Jun 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT008588 GA Primary

Addresses

Primary practice location

1514 Vernon Rd
Lagrange, GA 30240-4131

Mailing address

117 College Ave
Lagrange, GA 30240-3013
Phone (706) 302-2143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20090216000424 GA Practitioner - Physical Therapist in Private Practice 9234294877 Reassigns benefits to 1 organization
I20220826000157 NY Practitioner - Physical Therapist in Private Practice 9234294877 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leger Therapy Services Inc.Group PAC ID 6406853415, 16 clinicians

Practice addresses (Care Compare)

402 Bombay LN
Roswell, GA 30076-5826
Phone (678) 878-2503

4820 Genesee St
Cheektowaga, NY 14225-2410
Phone (770) 575-2212

500 Lanier Ave W
Suite 303
Fayetteville, GA 30214-7636
Phone (770) 716-8885

500 W Lanier Ave
Suite 303
Fayetteville, GA 30214-7636
Phone (770) 716-8885

965 Piedmont Rd NE
Suite 200
Marietta, GA 30066-5493
Phone (770) 575-2212

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT008588GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Leger Therapy Services Inc. CurrentSince Feb 1, 2008 Accepting new patients

Locations

500 Lanier Ave W
Ste 303
Fayetteville, GA 30214
Phone (770) 716-8885

4820 Genesee St
Cheektowaga, NY 14225
Phone (770) 575-2212

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": "1181174400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134322100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 COLLEGE AVE",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302403013",
            "telephone_number": "706-302-2143",
            "fax_number": "706-845-3700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1514 VERNON RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404131",
            "telephone_number": "706-845-3677",
            "fax_number": "706-845-3700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "JOSHUA",
        "middle_name": "YOUNG",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008588",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.