Individual provider Active NPI

Sterly Mary Philip, PT, DPT

  • Physical Therapist
  • Cedartown, GA
National Provider Identifier
1245805225
Registry record updated Sep 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT014013 Issued in GA
Practice address
1566 Rome Hwy
Cedartown, GA 30125-4403
Phone
(770) 749-0250
Fax
(770) 749-0086
NPI assigned
May 23, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2022

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X CP007690T TX
Physical Therapist 225100000X PT-5179-0 HI
Physical Therapist 225100000X PT014013 GA Primary

Addresses

Primary practice location

1566 Rome Hwy
Cedartown, GA 30125-4403

Mailing address

PO Box 949
Rome, GA 30162-0949
Phone (770) 749-0250

Other practice location 1

5833 W Interstate 20
Arlington, TX 76017-1057
Phone (817) 516-1115

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221014002686 GA Practitioner - Physical Therapist in Private Practice 4981070943 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Esop Rehabilitation LLCGroup PAC ID 9739305749, 224 clinicians

Practice addresses (Care Compare)

199 Medical Blvd
Stockbridge, GA 30281-5083
Phone (470) 781-9440

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT-5179-0HIMDPhysical Therapist
CP007690TTXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Esop Rehabilitation, LLC Physical Therapist CurrentSince Sep 20, 2023 Accepting new patients
Esop Rehabilitation LLC Physical Therapist Current Accepting new patients
Esop Rehabilitation, LLC Physical Therapist CurrentSince Sep 20, 2023 Accepting new patients
Green Oaks Physical Therapy Limited Partnership Physical Therapist PastSince Aug 1, 2021 Accepting new patients
Green Oaks Physical Therapy Limited Partnership Physical Therapist PastSince Aug 1, 2021 Accepting new patients

Locations

875 Flat Shoals Rd SE
Ste 150
Conyers, GA 30094
Phone (770) 785-7669

199 Medical Blvd
Stockbridge, GA 30281
Phone (404) 735-8212

Organizations & group practices 5

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": "1621728000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664409600000",
    "number": "1245805225",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 949",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301620949",
            "telephone_number": "770-749-0250"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1566 ROME HWY",
            "city": "CEDARTOWN",
            "state": "GA",
            "postal_code": "301254403",
            "telephone_number": "770-749-0250",
            "fax_number": "770-749-0086"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5833 W Interstate 20",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "TX",
            "postal_code": "760171057",
            "country_code": "US",
            "telephone_number": "817-516-1115",
            "fax_number": "817-516-1104",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHILIP",
        "first_name": "STERLY",
        "middle_name": "MARY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-23",
        "last_updated": "2022-09-29",
        "certification_date": "2022-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "CP007690T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "HI",
            "license": "PT-5179-0",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014013",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedartown, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2022; 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.