Intensive Therapy Center of Georgia, Inc.

Primary specialty

Pediatric Physical TherapistTaxonomy code 2251P0200X

Legal business name

INTENSIVE THERAPY CENTER OF GEORGIA, INC.

Practice address

545 Old Norcross Rd
Suite 100
Lawrenceville, GA 30046-3389

Phone

(678) 377-2833

Fax

(678) 377-2882

NPI assigned

Jan 13, 2010

Last updated

Jan 13, 2010By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Amie Locicero, PTNPI 1194898940

Title

President

Phone

(678) 377-2833

Specialties & licenses 2

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Amie Alagood Locicero, P.T.

  • Physical Therapist
  • Lawrenceville, GA
  • NPI 1194898940
  Authorized official Same address or phone

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

{
    "created_epoch": "1263340800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263340800000",
    "number": "1134459175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "545 OLD NORCROSS RD",
            "address_2": "SUITE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463389",
            "telephone_number": "678-377-2833",
            "fax_number": "678-377-2882"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "545 OLD NORCROSS RD",
            "address_2": "SUITE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300463389",
            "telephone_number": "678-377-2833",
            "fax_number": "678-377-2882"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTENSIVE THERAPY CENTER OF GEORGIA, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-13",
        "last_updated": "2010-01-13",
        "status": "A",
        "authorized_official_last_name": "LOCICERO",
        "authorized_official_first_name": "AMIE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "678-377-2833",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pediatric Physical Therapist in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Pediatric Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 13, 2010; 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.