Active NPI
Stephanie Vanessa Malguy, PTA
- Physical Therapy Assistant
- Atlanta, GA
National Provider Identifier
1205553708
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- CP029337A
- Practice address
- 3750 Peachtree Rd NE
Atlanta, GA 30319-1385 - Phone
- (404) 261-6611
- NPI assigned
- Oct 25, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | A5876 | MD | |
| Student in an Organized Health Care Education/Training Program | 390200000X | MD | ||
| Physical Therapy Assistant | 225200000X | CP029337A | GA | Primary |
Addresses
Primary practice location
3750 Peachtree Rd NE
Atlanta, GA 30319-1385
Mailing address
101 Fieldstone CT
Frederick, MD 21702-3279
Phone (703) 740-6106
Other practice location 1
412 Malcolm Dr Ste 200
Westminster, MD 21157-6174
Phone (667) 367-5464
Other practice location 2
2101 Fairland Rd
Silver Spring, MD 20904-5427
Phone (301) 384-6161
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CP029337A | GA | MD | Physical Therapy Assistant |
| A5876 | MD | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1666656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709856000000",
"number": "1205553708",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 FIELDSTONE CT",
"city": "FREDERICK",
"state": "MD",
"postal_code": "217023279",
"telephone_number": "703-740-6106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3750 PEACHTREE RD NE",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303191385",
"telephone_number": "404-261-6611"
}
],
"practiceLocations": [
{
"address_1": "412 Malcolm Dr Ste 200",
"address_purpose": "LOCATION",
"city": "Westminster",
"state": "MD",
"postal_code": "211576174",
"country_code": "US",
"telephone_number": "667-367-5464",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2101 Fairland Rd",
"address_purpose": "LOCATION",
"city": "Silver Spring",
"state": "MD",
"postal_code": "209045427",
"country_code": "US",
"telephone_number": "301-384-6161",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "MALGUY",
"first_name": "STEPHANIE",
"middle_name": "VANESSA",
"credential": "PTA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-10-25",
"last_updated": "2024-03-08",
"certification_date": "2024-03-08",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapy Assistant",
"state": "MD",
"license": "A5876",
"primary": false
},
{
"code": "390200000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Student in an Organized Health Care Education/Training Program",
"state": "MD",
"license": null,
"primary": false
},
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "GA",
"license": "CP029337A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlanta, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.