Organization Active NPI

Dynamic PT & Rehab, Inc

  • Physical Therapist
  • Blairsville, GA
National Provider Identifier
1154329464
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
DYNAMIC PT & REHAB, INC
Practice address
262 Highway 515
Suite C
Blairsville, GA 30512-3585
Phone
(706) 781-2875
Fax
(706) 781-2876
NPI assigned
Jul 11, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Kelly Moore Schiller, MPT
Title
President/Owner
Phone
(706) 781-2875

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

262 Highway 515
Suite C
Blairsville, GA 30512-3585

Mailing address

262 Highway 515
Suite C
Blairsville, GA 30512-3585
Phone (706) 781-2875

Other identifiers 1

IdentifierTypeStateIssuer
00803547AMedicaidGA

National Provider Directory

National Provider Directory

Locations

262 Highway 515
Ste C
Blairsville, GA 30512
Phone (706) 781-2875

NPI Registry JSON

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

{
    "created_epoch": "1121040000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1154329464",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "262 HIGHWAY 515",
            "address_2": "SUITE C",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305123585",
            "telephone_number": "706-781-2875",
            "fax_number": "706-781-2876"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "262 HIGHWAY 515",
            "address_2": "SUITE C",
            "city": "BLAIRSVILLE",
            "state": "GA",
            "postal_code": "305123585",
            "telephone_number": "706-781-2875",
            "fax_number": "706-781-2876"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DYNAMIC PT & REHAB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-07-11",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SCHILLER",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "MOORE",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "706-781-2875",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00803547A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Blairsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.