Individual provider Active NPI

Timothy Villamater, PT, DPT

  • Physical Therapist
  • Loganville, GA
National Provider Identifier
1194452029
Registry record updated Mar 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT016172 Issued in GA
Practice address
3440 Highway 81
Loganville, GA 30052-9112
Phone
(770) 554-5009
Fax
(706) 549-1663
NPI assigned
Aug 2, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2024

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 PT016172 GA Primary

Addresses

Primary practice location

3440 Highway 81
Loganville, GA 30052-9112

Mailing address

1765 Old West Broad St BLDG 2-200
Athens, GA 30606-2887
Phone (706) 549-1663

Other practice location 1

705 Breedlove Dr Ste 200
Monroe, GA 30655-2080
Phone (770) 554-5009

Other practice location 2

1765 Old West Broad St
Athens, GA 30606-2853
Phone (706) 549-1663

Other identifiers 1

IdentifierTypeStateIssuer
15679891OtherCAQH NUMBER

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address timothy.villamater.1@28045.direct.athenahealth.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220907002439 GA Practitioner - Physical Therapist in Private Practice 0244614402 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Athens Orthopedic Clinic, PAGroup PAC ID 5991600181, 70 clinicians

Practice addresses (Care Compare)

3440 Hwy 81
Loganville, GA 30052-9112
Phone (770) 554-5009

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Athens Orthopedic Clinic, PA CurrentSince Aug 22, 2022 Accepting new patients
Athens Orthopedic Clinic, PA CurrentSince Aug 22, 2022 Accepting new patients
Pediatric Orthopedic Associates Past Accepting new patients

Locations

1765 Old West Broad St
Ste 200
Athens, GA 30606
Phone (706) 433-4088

1765 Old West Broad St
Athens, GA 30606
Phone (706) 548-6881

1765 Old West Broad St
Bldg 2-200
Athens, GA 30606
Phone (706) 433-4088

3440 Highway 81
Loganville, GA 30052
Phone (770) 554-5009

705 Breedlove Dr
Ste 200
Monroe, GA 30655
Phone (770) 207-5738

Interoperability endpoints

  • Direct secure messaging: timothy.villamater.1@28045.direct.athenahealth.com

Organizations & group practices 3

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": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710115200000",
    "number": "1194452029",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 OLD WEST BROAD ST BLDG 2-200",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062887",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3440 HIGHWAY 81",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300529112",
            "telephone_number": "770-554-5009",
            "fax_number": "706-549-1663"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 Breedlove Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "GA",
            "postal_code": "306552080",
            "country_code": "US",
            "telephone_number": "770-554-5009",
            "fax_number": "706-546-8792",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1765 Old West Broad St",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306062853",
            "country_code": "US",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VILLAMATER",
        "first_name": "TIMOTHY",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-08-02",
        "last_updated": "2024-03-11",
        "certification_date": "2024-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT016172",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH NUMBER",
            "identifier": "15679891",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "timothy.villamater.1@28045.direct.athenahealth.com",
            "affiliation": "N",
            "endpointDescription": "Athena Direct Address",
            "address_1": "3440 Highway 81",
            "city": "Loganville",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300529112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Loganville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2024; 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.