NPIMap

Organization Active NPI

Therasport Physical Therapy Inc.

  • Physical Therapy Clinic/Center
  • Johns Creek, GA
National Provider Identifier
1194887315
Registry record updated Apr 12, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
THERASPORT PHYSICAL THERAPY INC.
Practice address
10160 Medlock Bridge Rd
Ste B
Johns Creek, GA 30097-4419
Phone
(678) 584-1622
Fax
(678) 584-1673
NPI assigned
Dec 14, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2011

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

Authorized official

Name
Mr. Stephen Nicholas Arroyo, PT, ATCNPI 1477587475
Title
Cheif Finacial Officer
Phone
(678) 584-1622

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

10160 Medlock Bridge Rd
Ste B
Johns Creek, GA 30097-4419

Mailing address

PO Box 923387
Norcross, GA 30010-3387
Phone (678) 584-1622

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050915000453 GA Part B Supplier - Clinic/Group Practice 0143253575 Receives reassigned benefits from 2 practitioners
Practice locations: Johns Creek, GA

National Provider Directory

National Provider Directory

Locations

3645 Howell Ferry Rd
Ste B
Duluth, GA 30096
Phone (678) 584-1622

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302566400000",
    "number": "1194887315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 923387",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300103387",
            "telephone_number": "678-584-1622",
            "fax_number": "678-584-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10160 MEDLOCK BRIDGE RD",
            "address_2": "STE B",
            "city": "JOHNS CREEK",
            "state": "GA",
            "postal_code": "300974419",
            "telephone_number": "678-584-1622",
            "fax_number": "678-584-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERASPORT PHYSICAL THERAPY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-14",
        "last_updated": "2011-04-12",
        "status": "A",
        "authorized_official_last_name": "ARROYO",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "NICHOLAS",
        "authorized_official_title_or_position": "CHEIF FINACIAL OFFICER",
        "authorized_official_telephone_number": "678-584-1622",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT, ATC"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johns Creek, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 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.