Individual provider Active NPI

Jesus Manuel Garcia

  • Physical Therapist
  • Cedartown, GA
National Provider Identifier
1184047151
Registry record updated Jan 27, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT015113 Issued in GA
Practice address
1566 Rome Hwy
Cedartown, GA 30125-4403
Phone
(770) 749-0250
Fax
(770) 749-0086
NPI assigned
Jan 28, 2014
Last updated
Jan 27, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 9684 TN
Physical Therapist 225100000X 7192 SC
Physical Therapist 225100000X 2013022021 MO
Physical Therapist 225100000X PT015113 GA Primary

Addresses

Primary practice location

1566 Rome Hwy
Cedartown, GA 30125-4403

Mailing address

PO Box 949
Rome, GA 30162-0949
Phone (770) 749-0250

Other practice location 1

852A Springfield Hwy
Goodlettsville, TN 37072-1127
Phone (615) 557-8433

Other practice location 2

115 Cumberland Plz
Crossville, TN 38555-4292
Phone (931) 787-1244

Other names 1

  • Jessie Garcia Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN, GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20140623001340 TN Practitioner - Physical Therapist in Private Practice 3577787167 Reassigns benefits to 2 organizations
I20210519000100 GA Practitioner - Physical Therapist in Private Practice 3577787167 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Results-Ast JV LLCGroup PAC ID 4486066396, 390 clinicians

Practice addresses (Care Compare)

262 New Shackle Island Rd
Suite 210
Hendersonville, TN 37075-2489
Phone (615) 507-1552

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
9684TNMDDentist
2013022021MOMDPhysical Therapist
7192SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy, LLC Physical Therapist CurrentSince Jan 13, 2020 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Apr 5, 2021 Accepting new patients
Results-Ast JV, LLC Physical Therapist CurrentSince Feb 28, 2022 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Apr 5, 2021 Accepting new patients
Advance Rehabilitation & Consulting Limited Partnership Physical Therapist PastSince Jan 31, 2021 Accepting new patients
Advance Rehabilitation & Consulting Limited Partnership Physical Therapist PastSince Jan 31, 2021 Accepting new patients

Locations

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

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

1394 Battlefield Pkwy
Ft Oglethorpe, GA 30742
Phone (706) 858-0252

400 Tower Rd NE
Ste 140
Marietta, GA 30060
Phone (770) 419-9437

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (866) 518-0283

1202 N Charles G Seivers Blvd
Ste A
Clinton, TN 37716
Phone (865) 457-0192

115 Cumberland Plz
Crossville, TN 38555
Phone (931) 787-1244

262 New Shackle Island Rd
Ste 210
Hendersonville, TN 37075
Phone (615) 507-1552

326 New Shackle Island Rd
Ste 300
Hendersonville, TN 37075
Phone (615) 448-0517

2030 Cowan Hwy
Ste 1
Winchester, TN 37398
Phone (931) 968-1080

Organizations & group practices 6

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": "1390867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611705600000",
    "number": "1184047151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 949",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301620949",
            "telephone_number": "770-749-0250",
            "fax_number": "770-749-0086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1566 ROME HWY",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301254403",
            "telephone_number": "770-749-0250",
            "fax_number": "770-749-0086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "852A Springfield Hwy",
            "address_purpose": "LOCATION",
            "city": "Goodlettsville",
            "state": "TN",
            "postal_code": "370721127",
            "country_code": "US",
            "telephone_number": "615-557-8433",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "115 Cumberland Plz",
            "address_purpose": "LOCATION",
            "city": "Crossville",
            "state": "TN",
            "postal_code": "385554292",
            "country_code": "US",
            "telephone_number": "931-787-1244",
            "fax_number": "931-787-1245",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARCIA",
        "first_name": "JESUS",
        "middle_name": "MANUEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-01-28",
        "last_updated": "2021-01-27",
        "certification_date": "2021-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TN",
            "license": "9684",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "7192",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MO",
            "license": "2013022021",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT015113",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSIE",
            "last_name": "GARCIA",
            "credential": "PT, DPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Cedartown, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2021; 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.