Individual provider Active NPI

Matthew Johnson

  • Physical Therapist
  • Douglasville, GA
National Provider Identifier
1154094720
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP008837T Issued in GA
Practice address
2750 Chapel Hill Rd Ste 1200
Douglasville, GA 30135-1721
Phone
(678) 981-6290
NPI assigned
Jul 29, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X
Physical Therapist 225100000X CP008837T GA Primary

Addresses

Primary practice location

2750 Chapel Hill Rd Ste 1200
Douglasville, GA 30135-1721

Mailing address

6397 Lee Hwy
Chattanooga, TN 37421-2564
Phone (423) 238-3473

Other practice location 1

84 Highland Ave Ste 201
Salem, MA 01970-2736
Phone (978) 741-0880

Other practice location 2

11490 Alpharetta Hwy Ste 200
Roswell, GA 30076-3866
Phone (770) 740-8592

Other practice location 3

1205 Johnson Ferry Rd Ste 130
Marietta, GA 30068-5401
Phone (770) 565-3201

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220225001457 GA Practitioner - Physical Therapist in Private Practice 6800293663 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

11490 Alpharetta Hwy
Suite 200
Roswell, GA 30076-3866
Phone (770) 740-8592

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy, Inc CurrentSince Feb 21, 2022 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Feb 21, 2022 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Feb 21, 2022 Accepting new patients
Benchmark Physical Therapy Inc Physical Therapist CurrentSince Feb 21, 2022 Accepting new patients
Drayer Physical Therapy Georgia LLC Physical Therapist CurrentSince Feb 21, 2022 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

2750 Chapel Hill Rd
Ste 1200
Douglasville, GA 30135
Phone (678) 981-6290

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

3455 Highway 81
Loganville, GA 30052
Phone (678) 635-8280

1205 Johnson Ferry Rd
Ste 130
Marietta, GA 30068
Phone (770) 565-3201

11490 Alpharetta Hwy
Ste 200
Roswell, GA 30076
Phone (770) 740-8592

1498 Hudson Bridge Rd
Stockbridge, GA 30281
Phone (678) 289-0525

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

Organizations & group practices 5

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": "1627516800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1154094720",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212564",
            "telephone_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2750 CHAPEL HILL RD STE 1200",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301351721",
            "telephone_number": "678-981-6290"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "84 Highland Ave Ste 201",
            "address_purpose": "LOCATION",
            "city": "Salem",
            "state": "MA",
            "postal_code": "019702736",
            "country_code": "US",
            "telephone_number": "978-741-0880",
            "fax_number": "978-740-5595",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11490 Alpharetta Hwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300763866",
            "country_code": "US",
            "telephone_number": "770-740-8592",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1205 Johnson Ferry Rd Ste 130",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300685401",
            "country_code": "US",
            "telephone_number": "770-565-3201",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "MATTHEW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-07-29",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "CP008837T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 29, 2022; 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.