Individual provider Active NPI

Matthew Thomas Kilgore, PT, DPT

  • Physical Therapist
  • Woodstock, GA
National Provider Identifier
1235797663
Registry record updated Jun 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT013991 Issued in GA
Practice address
2295 Towne Lake Pkwy Ste 148
Woodstock, GA 30189-5520
Phone
(770) 926-2744
Fax
(770) 926-2794
NPI assigned
May 31, 2019
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2019

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 PT013991 GA Primary

Addresses

Primary practice location

2295 Towne Lake Pkwy Ste 148
Woodstock, GA 30189-5520

Mailing address

6397 Lee Hwy Ste 300
Chattanooga, TN 37421-4915
Phone (423) 238-7217

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, TN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20190730004588 GA Practitioner - Physical Therapist in Private Practice 3375879265 Reassigns benefits to 1 organization
I20221117000743 TN Practitioner - Physical Therapist in Private Practice 3375879265 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT013991GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy of Ga, LLC Physical Therapist CurrentSince Jun 7, 2019 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist Current Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jun 7, 2019 Accepting new patients
Results-Ast JV, LLC Physical Therapist CurrentSince Sep 26, 2022 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

2295 Towne Lake Pkwy
Ste 148
Woodstock, GA 30189
Phone (770) 926-2744

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

1802 N Jackson St
Ste 700
Tullahoma, TN 37388
Phone (931) 222-4482

2030 Cowan Hwy
Ste 1
Winchester, TN 37398
Phone (931) 968-1080

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1559260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1560124800000",
    "number": "1235797663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214915",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 TOWNE LAKE PKWY STE 148",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301895520",
            "telephone_number": "770-926-2744",
            "fax_number": "770-926-2794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILGORE",
        "first_name": "MATTHEW",
        "middle_name": "THOMAS",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-05-31",
        "last_updated": "2019-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT013991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2019; 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.