Individual provider Active NPI

Stephen Russell Weyandt, PT, DPT

  • Physical Therapist
  • Peachtree City, GA
National Provider Identifier
1164469565
Registry record updated May 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT6708 Issued in GA
Practice address
277 Highway 74 N
Suite 203
Peachtree City, GA 30269-1569
Phone
(678) 364-0337
Fax
(678) 364-0858
NPI assigned
Jun 2, 2006
Last updated
May 19, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2016

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 PT6708 GA Primary
Physical Therapist 225100000X PTH7978 AL

Addresses

Primary practice location

277 Highway 74 N
Suite 203
Peachtree City, GA 30269-1569

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, AL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20050922000540 GA Practitioner - Physical Therapist in Private Practice 5597799239 Reassigns benefits to 3 organizations
I20160622002791 AL Practitioner - Physical Therapist in Private Practice 5597799239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Benchmark Physical Therapy of Alabama, LLCGroup PAC ID 5698930444, 73 clinicians

Practice addresses (Care Compare)

153 Narrows Pkwy
Suite 101
Birmingham, AL 35242-8601
Phone (205) 981-4534

215 Davis Blvd
Bremen, GA 30110-2569
Phone (678) 821-3425

5009 River Chase Dr
Suite 100C
Phenix City, AL 36867-7484
Phone (334) 298-0650

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT6708GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy, Inc CurrentSince Sep 1, 2005 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Nov 26, 2013 Accepting new patients
Benchmark Physical Therapy, Inc CurrentSince Sep 1, 2005 Accepting new patients
Benchmark Physical Therapy of Alabama, LLC Physical Therapist CurrentSince May 30, 2016 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist Current Accepting new patients
Independent Physical Therapy of Ga, LLC CurrentSince Nov 26, 2013 Accepting new patients
Benchmark Physical Therapy of Alabama, LLC Physical Therapist Past Accepting new patients

Locations

153 Narrows Pkwy
Ste 101
Birmingham, AL 35242
Phone (205) 640-4881

151 Fly Creek Ave
Ste 438
Fairhope, AL 36532
Phone (251) 928-9619

3947 Gulf Shores Pkwy
Ste 260
Gulf Shores, AL 36542
Phone (251) 943-0803

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1713 Montgomery Hwy
Ste 131
Hoover, AL 35244
Phone (205) 403-8701

4500 Montevallo Rd
Ste E107
Irondale, AL 35210
Phone (205) 957-0870

7721 Airport Blvd
Ste E120
Mobile, AL 36608
Phone (251) 631-3680

2846 Moody Pkwy
Ste 200
Moody, AL 35004
Phone (205) 640-0257

5009 Riverchase Dr
Ste 100C
Phenix City, AL 36867
Phone (334) 291-5125

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

215 Davis Blvd
Bremen, GA 30110
Phone (678) 821-3425

909 S Park St
Ste E
Carrollton, GA 30117
Phone (770) 251-7284

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

277 Highway 74 N
Ste 203
Peachtree City, GA 30269
Phone (678) 364-0337

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

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

8823 Production Ln
Ooltewah, TN 37363
Phone (423) 238-8923

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1149206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463616000000",
    "number": "1164469565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "277 HIGHWAY 74 N",
            "address_2": "SUITE 203",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691569",
            "telephone_number": "678-364-0337",
            "fax_number": "678-364-0858"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEYANDT",
        "first_name": "STEPHEN",
        "middle_name": "RUSSELL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-02",
        "last_updated": "2016-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT6708",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH7978",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree City, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2016; 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.