Gregory Charles Pancake, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT014742 Issued in GA

Practice address

4446 Washington Rd Ste 8
Evans, GA 30809-6361

Phone

(706) 869-3352

Fax

(706) 869-3299

NPI assigned

Mar 24, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2013

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Independent Physical Therapy of Georgia, LLCGroup PAC ID 2961312244, 526 clinicians

Practice addresses (Care Compare)

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.

• Independent Physical Therapy of Georgia, LLC

  dba BenchMark Physical Therapy

  • Physical Therapist
  • Fort Oglethorpe, GA
  • NPI 1780636068
  Medicare reassignment Care Compare group NPD
• Benchmark Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Duluth, GA
  • NPI 1083666903
  Medicare reassignment
• Agilitas USA Inc

  dba Results Physiotherapy

  • Physical Therapy Clinic/Center
  • Hixson, TN
  • NPI 1962417444

  GA

  Medicare reassignment
• Independent Physical Therapy of Georgia, LLC

  dba Benchmark PT

  • Occupational Therapist
  • Gainesville, GA
  • NPI 1306013941

  Physical Therapist

  NPD
• Ivyrehab North Carolina LLC

  • Physical Medicine & Rehabilitation Physician
  • Charlotte, NC
  • NPI 1528683935
  NPD (past)

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

{
    "created_epoch": "1395619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612483200000",
    "number": "1235556721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-2717",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4446 WASHINGTON RD STE 8",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308096361",
            "telephone_number": "706-869-3352",
            "fax_number": "706-869-3299"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1129 E Marion St",
            "address_purpose": "LOCATION",
            "city": "Shelby",
            "state": "NC",
            "postal_code": "281504843",
            "country_code": "US",
            "telephone_number": "704-471-0001 x102",
            "fax_number": "704-471-9990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANCAKE",
        "first_name": "GREGORY",
        "middle_name": "CHARLES",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-03-24",
        "last_updated": "2021-02-05",
        "certification_date": "2021-02-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "14739",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher P Owens
• Cindy Pafford
• Stacy Page, CSA
• Pain Management & Rehabilitation Specialists, PC (PM&R Specialists, PC)
• Pain Management & Rehabilitation Specialists, PC
• Erin Park, LPC
• Bailey Olivia Parker, OT, MOT
• Christopher Patrick Parker, RPH
• Monica Parsons I
• Teresa K Parton, P.T.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2021; 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.