Individual provider Active NPI

Deanna Brubaker, PT

  • Physical Therapist
  • Loganville, GA
National Provider Identifier
1194896076
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT008761 Issued in GA
Practice address
150 Athens Hwy
Loganville, GA 30052-2277
Phone
(770) 554-2307
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT008761 GA Primary

Addresses

Primary practice location

150 Athens Hwy
Loganville, GA 30052-2277

Mailing address

PO Box 518
Jonesboro, GA 30237-0518
Phone (770) 631-8277

Other identifiers 1

IdentifierTypeStateIssuer
PT008761OtherGASTATE LISC NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130502000184 GA Practitioner - Physical Therapist in Private Practice 6305083718 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians
Integrated Therapy LLCGroup PAC ID 1153317300, 48 clinicians

Practice addresses (Care Compare)

1641 Virgil Langford Rd
Watkinsville, GA 30677-7293
Phone (706) 534-1400

255 Vaughn Dr
Alpharetta, GA 30009-2415
Phone (770) 521-9707

2881 Monroe Hwy
Suite 501
Bogart, GA 30622-8529
Phone (706) 534-1400

562 Research Dr
Athens, GA 30605-2730
Phone (404) 351-5307

901 Haymon Morris Rd
Winder, GA 30680-7837
Phone (678) 705-2123

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Jul 3, 2023 Accepting new patients
Legacy Healthcare Services, Inc. Physical Therapist CurrentSince Jul 19, 2023 Accepting new patients
Integrated Therapy LLC Physical Therapist CurrentSince Aug 12, 2024 Accepting new patients
Legacy Healthcare Services, Inc. Physical Therapist CurrentSince Jul 3, 2023 Accepting new patients
Physiotherapy Associates Physical Therapist Past Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients
Life Clinic of Ga PC Physical Therapist PastSince Dec 3, 2022 Accepting new patients

Locations

855 North Point Pkwy
Alpharetta, GA 30005
Phone (952) 401-2336

915 Hawthorne Ave
Athens, GA 30606

562 Research Dr
Athens, GA 30605

2221 Peachtree Rd NE
Ste D336
Atlanta, GA 30309

3333 E Cherokee Dr
Canton, GA 30115
Phone (470) 714-6698

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

Organizations & group practices 7

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": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1194896076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 518",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302370518",
            "telephone_number": "770-631-8277",
            "fax_number": "770-631-9403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 ATHENS HWY",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300522277",
            "telephone_number": "770-554-2307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRUBAKER",
        "first_name": "DEANNA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008761",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISC NUMBER",
            "identifier": "PT008761",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "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 Jul 8, 2007; 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.