Kristoffer Totanes Magallanes
Individual provider Active NPI Physical Therapist · Eastanollee, GA
NPI 1134836984 · NPPES record last updated Mar 21, 2023
Key facts
- NPI
- 1134836984
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT016489 (GA)
- Practice address
- 201 Walmart Way
Eastanollee, GA 30538 - Phone
- (706) 282-1025
- Fax
- (706) 886-8156
- NPI assigned
- Nov 1, 2022
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 18
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Independent Physical Therapy of Georgia, LLC
Benchmark Physical Therapy, Inc
Agilitas USA, Inc
Practice addresses (Care Compare)
2515 Fence Rd
Suite 160
Dacula, GA 30019-2138
Phone (770) 237-2852
3790 Pleasant Hill Rd
Suite 100
Duluth, GA 30096-5143
Phone (770) 497-4228
4135 Lavista Rd
Suite 110
Tucker, GA 30084-5325
Phone (470) 568-2622
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20230331001702 | GA | Practitioner - Physical Therapist in Private Practice | 4183099336 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 12120 | CT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Benchmark Physical Therapy Inc | Physical Therapist | Current |
Accepting new patients |
| Agilitas USA, Inc | Physical Therapist | Current |
Accepting new patients |
| Benchmark Physical Therapy, Inc | Current |
Accepting new patients | |
| Independent Physical Therapy of Georgia, LLC | Physical Therapist | Current |
Accepting new patients |
| Drayer Physical Therapy Georgia LLC | Physical Therapist | Current |
Accepting new patients |
| Agilitas USA Inc | Physical Therapist | Current |
Accepting new patients |
| Independent Physical Therapy of Georgia, LLC | Physical Therapist | Current |
Accepting new patients |
Locations
1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568
1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001
7201 Turner Lake Rd NW
Ste 13
Covington, GA 30014
Phone (470) 444-1609
2515 Fence Rd
Ste 160
Dacula, GA 30019
Phone (770) 237-2852
210 Walmart Way
Eastanollee, GA 30538
Phone (706) 282-1025
7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660
4145 Lawrenceville Hwy NW
Ste 8
Lilburn, GA 30047
Phone (678) 691-7163
3455 Highway 81
Loganville, GA 30052
Phone (678) 635-8280
11490 Alpharetta Hwy
Ste 200
Roswell, GA 30076
Phone (770) 740-8592
4135 Lavista Rd
Ste 110
Tucker, GA 30084
Phone (470) 568-2622
6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 12120 | CT | |
| Physical Therapist | 225100000X | PT016489 | GA | Yes |
Addresses
Primary practice location
201 Walmart Way
Eastanollee, GA 30538
Mailing address
1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (866) 518-0283
Other practice location 1
1580 Sawgrass Corporate Pkwy Ste 200
Sunrise, FL 33323-2869
Phone (954) 739-4247
Other providers in Eastanollee, GA
- Independent Physical Therapy of Ga, LLC
- Lincare Inc.
- Lowery Dental Group PC
- Elizabeth Bailey Lowery
- Vasco. Alexander Lowery III
- Noel Pauley
- Ernest R Prow III
- Andrea Reganato
- Reins of Life Inc
- Trinity Nemt LLC
All providers in Eastanollee, GA · Physical Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 21, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.