NPIMap

Organization Active NPI

Orthopedic and Sports Physical Therapy, Inc.

  • Physical Therapist
  • Tifton, GA
National Provider Identifier
1194796789
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT001108 Issued in GA
Legal business name
ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, INC.
Practice address
1488 Old Ocilla Rd
Tifton, GA 31794-4152
Phone
(229) 386-5200
Fax
(229) 386-1412
NPI assigned
Jan 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Anthony (Andy) F Ellis
Title
President
Phone
(229) 386-5200

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT001108 GA Primary

Addresses

Primary practice location

1488 Old Ocilla Rd
Tifton, GA 31794-4152

Mailing address

1488 Old Ocilla Rd
Tifton, GA 31794-4152
Phone (229) 386-5200

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1194796789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1488 OLD OCILLA RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944152",
            "telephone_number": "229-386-5200",
            "fax_number": "229-386-1412"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1488 OLD OCILLA RD",
            "city": "TIFTON",
            "state": "GA",
            "postal_code": "317944152",
            "telephone_number": "229-386-5200",
            "fax_number": "229-386-1412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC AND SPORTS PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-01-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ELLIS",
        "authorized_official_first_name": "ANTHONY (ANDY)",
        "authorized_official_middle_name": "F",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "229-386-5200"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT001108",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tifton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.