Individual provider Active NPI

Cory Buice, DPT

  • Physical Therapist
  • Douglasville, GA
National Provider Identifier
1174828073
Registry record updated Jan 24, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
010148 Issued in GA
Practice address
3614 Highway 5
Douglasville, GA 30135-2314
Phone
(770) 489-9332
NPI assigned
Jan 24, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 24, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 010148 GA Primary

Addresses

Primary practice location

3614 Highway 5
Douglasville, GA 30135-2314

Mailing address

3614 Highway 5
Douglasville, GA 30135-2314
Phone (770) 489-9332

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110217000584 GA Practitioner - Physical Therapist in Private Practice 5698956084 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Associates Inc CurrentSince Oct 1, 2024 Accepting new patients
Mark a Ellis, MD, PC CurrentSince Sep 1, 2013 Accepting new patients
Physiotherapy Associates Inc Current Accepting new patients
Physiotherapy Associates, Inc Physical Therapist CurrentSince Oct 1, 2024 Accepting new patients
Jorge a. Bueno Chiropractic LLC PastSince Mar 26, 2011 Accepting new patients

Locations

4700 Nelson Brogdon Blvd
Ste 240
Buford, GA 30518
Phone (770) 271-3188

966A Killian Hill Rd SW
Lilburn, GA 30047
Phone (770) 923-4815

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": "1295827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1295827200000",
    "number": "1174828073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3614 HIGHWAY 5",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301352314",
            "telephone_number": "770-489-9332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3614 HIGHWAY 5",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301352314",
            "telephone_number": "770-489-9332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BUICE",
        "first_name": "CORY",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-01-24",
        "last_updated": "2011-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "010148",
            "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 Jan 24, 2011; 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.