John Kenneth Clucas, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT014979 Issued in GA

Practice address

5415 Thompson Mill Rd
Hoschton, GA 30548-4132

Phone

(770) 965-3508

Fax

(770) 965-3279

NPI assigned

Jun 7, 2017

Last updated

Jan 25, 2021By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1496793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611532800000",
    "number": "1245769892",
    "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": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5415 THOMPSON MILL RD",
            "city": "HOSCHTON",
            "state": "GA",
            "postal_code": "305484132",
            "telephone_number": "770-965-3508",
            "fax_number": "770-965-3279"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2793 Black Rd",
            "address_purpose": "LOCATION",
            "city": "Joliet",
            "state": "IL",
            "postal_code": "604352926",
            "country_code": "US",
            "telephone_number": "815-725-9134",
            "fax_number": "815-725-9190",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CLUCAS",
        "first_name": "JOHN",
        "middle_name": "KENNETH",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-06-07",
        "last_updated": "2021-01-25",
        "certification_date": "2021-01-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070023050",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Castaneda, DC
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• Laverne Chin
• Dorrett Chonge, LMFT
• Cognitive Behavioral Health LLC
• Cynthia Collins, P.T.
• Delores Ann Combsbarnes, D.P.M.
• Alisha Conner, NP-C
• Robert Lee Cornett, PT

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 25, 2021; 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.