Carol Ann Collica, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT004494 Issued in GA

Practice address

444 Park West Drive
Grovetown, GA 30813

Phone

(706) 868-6543

Fax

(706) 868-9579

NPI assigned

Nov 17, 2006

Last updated

Jul 9, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Augusta Developmental Specialists, LLC

  • Developmental - Behavioral Pediatrics Physician
  • Augusta, GA
  • NPI 1932487691
  Medicare reassignment NPD
• Apparo Academy, Inc.

  • Speech-Language Pathologist
  • Augusta, GA
  • NPI 1811457831
  NPD (past)

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

{
    "created_epoch": "1163721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1194898825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "483 OLD WALNUT BR",
            "city": "NORTH AUGUSTA",
            "state": "SC",
            "postal_code": "298608662",
            "telephone_number": "803-441-8291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "444 PARK WEST DRIVE",
            "city": "GROVETOWN",
            "state": "GA",
            "postal_code": "30813",
            "telephone_number": "706-868-6543",
            "fax_number": "706-868-9579"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLLICA",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-17",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT004494",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "2753",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "617152988A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cassidy Clifford, OTR/L
• Stanley P. Coe, MD
• Nicole Coffey
• Christine Cole
• Virginia Cole
• Audrenee Collins
• Columbia County Board of Health
• Columbia County Board of Health (Columbia County Health Deppartment)
• Columbia County Emergency Physicians, LLC
• Jaclyn Ashley Combs

• Physical Therapist in Grovetown, GA
• Providers in Grovetown, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; 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.