Proactive Athletic Performance LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PROACTIVE ATHLETIC PERFORMANCE LLC

Practice address

9 Dunwoody Park South # 14
Dunwoody, GA 30338-7407

Phone

(580) 917-6326

NPI assigned

Nov 2, 2023

Last updated

Nov 2, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Daniel W Bodkin, PT, DPT, ATCNPI 1659626497

Title

Owner / Physical Therapist

Phone

(580) 917-6326

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Daniel Wayne Bodkin, PT,DPT,ATC

  • Physical Therapist
  • Tampa, FL
  • NPI 1659626497
  NPD Authorized official

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

{
    "created_epoch": "1698883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698883200000",
    "number": "1174396097",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 DUNWOODY PARK SOUTH # 14",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303387407",
            "telephone_number": "580-917-6326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9 DUNWOODY PARK SOUTH # 14",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303387407",
            "telephone_number": "580-917-6326"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE ATHLETIC PERFORMANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-02",
        "last_updated": "2023-11-02",
        "certification_date": "2023-11-02",
        "status": "A",
        "authorized_official_last_name": "BODKIN",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "OWNER / PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "580-917-6326",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT, ATC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Dunwoody, GA
• Providers in Dunwoody, GA by specialty
• Physical Therapy Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2023; 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.