NPIMap

Organization Active NPI

Kwon Physical Therapy LLC

  • Physical Therapist
  • Duluth, GA
National Provider Identifier
1154932200
Registry record updated Jun 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
KWON PHYSICAL THERAPY LLC
Practice address
3473 Satellite Blvd # 108N
Duluth, GA 30096-8690
Phone
(470) 550-1271
Fax
(404) 506-9900
NPI assigned
Aug 12, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 22, 2022

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

Authorized official

Name
Kiseok Kwon, DPTNPI 1508234311
Title
Owner
Phone
(470) 550-1271

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

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

Addresses

Primary practice location

3473 Satellite Blvd # 108N
Duluth, GA 30096-8690

Mailing address

3473 Satellite Blvd # 108N
Duluth, GA 30096-8690
Phone (470) 550-1271

Other practice location 1

3420 Paddocks Pkwy
Suwanee, GA 30024-9120
Phone (470) 550-1271

Other names 1

  • Fit In Motion Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220526001349 GA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0941688311 Receives reassigned benefits from 7 practitioners
Practice locations: Duluth, GA; Suwanee, GA

National Provider Directory

National Provider Directory

Locations

3473 Satellite Blvd
#108N
Duluth, GA 30096
Phone (470) 550-1271

3473 Satellite Blvd
Ste 108N
Duluth, GA 30096
Phone (470) 550-1271

Practitioners & affiliated clinicians

Practitioners 7

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1597190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655856000000",
    "number": "1154932200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3473 SATELLITE BLVD # 108N",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968690",
            "telephone_number": "470-550-1271",
            "fax_number": "404-506-9900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3473 SATELLITE BLVD # 108N",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300968690",
            "telephone_number": "470-550-1271",
            "fax_number": "404-506-9900"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3420 Paddocks Pkwy",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300249120",
            "country_code": "US",
            "telephone_number": "470-550-1271",
            "fax_number": "404-506-9900",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "KWON PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-08-12",
        "last_updated": "2022-06-22",
        "certification_date": "2022-06-22",
        "status": "A",
        "authorized_official_last_name": "KWON",
        "authorized_official_first_name": "KISEOK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-550-1271",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fit In Motion Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Fit In Motion Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Duluth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.