NPIMap

Individual provider Active NPI

Spencer Andrew Wingate, PT

  • Physical Therapist
  • Villa Rica, GA
National Provider Identifier
1205988789
Registry record updated Apr 17, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT003181 Issued in GA
Practice address
921 Moores Ferry Rd
Suite D
Villa Rica, GA 30180-9703
Phone
(678) 840-8881
Fax
(678) 840-8885
NPI assigned
Jan 17, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X PT003181 GA
Physical Therapist 225100000X PT003181 GA Primary

Addresses

Primary practice location

921 Moores Ferry Rd
Suite D
Villa Rica, GA 30180-9703

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Occupational Health Centers of Georgia Past Accepting new patients
Occupational Health Centers of Georgia PC Past Accepting new patients
Occupational Health Centers of Georgia, P.C. Past Accepting new patients
Occupational Health Centers of Georgia PC Past Accepting new patients
Occupational Health Centers of Georgia PC Past Accepting new patients
Occupational Health Centers of Georgia, P.C. Past Accepting new patients
Atlanta Knee and Shoulder Clinic PC Specialist Past Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397692800000",
    "number": "1205988789",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-954-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "921 MOORES FERRY RD",
            "address_2": "SUITE D",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301809703",
            "telephone_number": "678-840-8881",
            "fax_number": "678-840-8885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WINGATE",
        "first_name": "SPENCER",
        "middle_name": "ANDREW",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2014-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "PT003181",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT003181",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villa Rica, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2014; 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.