Individual provider Active NPI

Suzanne Castano, PT

  • Physical Therapist
  • Duluth, GA
National Provider Identifier
1235208190
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT006721 Issued in GA
Practice address
10090 Medlock Bridge Rd
Suite100
Duluth, GA 30097-4428
Phone
(770) 813-5575
NPI assigned
Nov 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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 PT006721 GA Primary

Addresses

Primary practice location

10090 Medlock Bridge Rd
Suite100
Duluth, GA 30097-4428

Mailing address

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

Other identifiers 1

IdentifierTypeStateIssuer
PT006721OtherGASTATE LISC NUMBER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201215000475 GA Practitioner - Physical Therapist in Private Practice 1951713064 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Magnolia Physical Therapy and WellnessGroup PAC ID 5496005639, 2 clinicians

Practice addresses (Care Compare)

420 Elden Dr
Atlanta, GA 30342-2034
Phone (678) 343-6660

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006721GAMDProfessional Counselor
PT006721GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab Associates, LLC Physical Therapist Past Accepting new patients
Physiotherapy Associates Physical Therapist Past Accepting new patients
Rehab Associates, LLC Past Accepting new patients
Physiotherapy Associates, Inc. Physical Therapist Past Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients

Organizations & group practices 6

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1235208190",
    "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": "30237",
            "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": "10090 MEDLOCK BRIDGE RD",
            "address_2": "SUITE100",
            "city": "DULUTH",
            "state": "GA",
            "postal_code": "300974428",
            "telephone_number": "770-813-5575"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CASTANO",
        "first_name": "SUZANNE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT006721",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LISC NUMBER",
            "identifier": "PT006721",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Duluth, 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.