Caroline Smith Petmecky

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT016155 Issued in GA

Practice address

204 Resource LN
Winder, GA 30680-8361

Phone

(678) 963-0694

NPI assigned

Aug 23, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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 and National Provider Directory roles.

• Integrated Therapy LLC

  • Physical Therapist
  • Atlanta, GA
  • NPI 1326247248
  Medicare reassignment NPD
• Let'S Communicate, Inc

  • Speech-Language Pathologist
  • Winder, GA
  • NPI 1467696393
  NPD (past)
• Life Clinic of Ga PC

  • Chiropractor
  • Woodstock, GA
  • NPI 1922752807

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1661212800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692576000000",
    "number": "1225757461",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 RESOURCE LN",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306808361",
            "telephone_number": "678-963-0694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 RESOURCE LN",
            "city": "WINDER",
            "state": "GA",
            "postal_code": "306808361",
            "telephone_number": "678-963-0694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETMECKY",
        "first_name": "CAROLINE",
        "middle_name": "SMITH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-23",
        "last_updated": "2023-08-21",
        "certification_date": "2023-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT016155",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Paul
• Kathey J. Payne, CRNA
• Angela Peavy, M.ED.
• Charles Fink Peebles, DPM
• Tami C Pennington, LPC
• Lewis H. Petree, D.M.D.
• Margaret Petree, DMD
• Pamela Johns Pillon
• Rafael Pinzon
• Madison Pitt

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2023; 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.