NPIMap

Organization Active NPI

Emory Physical Therapy, LLC

  • Physical Therapist
  • Decatur, GA
National Provider Identifier
1245863174
Registry record updated Aug 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
EMORY PHYSICAL THERAPY, LLC
Practice address
487 Winn Way
Decatur, GA 30030-1735
Phone
(404) 251-2007
Fax
(404) 371-9112
NPI assigned
Feb 19, 2020
Last updated
Aug 26, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 26, 2024

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

Authorized official

Name
Gregory L Cooper
Title
Authorized Official
Phone
(219) 365-6560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

487 Winn Way
Decatur, GA 30030-1735

Mailing address

PO Box 102831
Atlanta, GA 30368-2831
Phone (404) 251-2007

Other practice location 1

1014 Sycamore Dr
Decatur, GA 30030-1644
Phone (404) 251-2007

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041019000776 GA Part B Supplier - Clinic/Group Practice 1153382676 Receives reassigned benefits from 310 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jonesboro, GA; Tucker, GA; Smyrna, GA; Lithonia, GA; Lagrange, GA; Johns Creek, GA; Flowery Branch, GA; Dunwoody, GA…

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Emory Physical Therapy LLC14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

6335 Hospital Pkwy
Ste 316
Johns Creek, GA 30097
Phone (404) 778-6447

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1582070400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724630400000",
    "number": "1245863174",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102831",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682831",
            "telephone_number": "404-251-2007",
            "fax_number": "404-371-9112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "487 WINN WAY",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301735",
            "telephone_number": "404-251-2007",
            "fax_number": "404-371-9112"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1014 Sycamore Dr",
            "address_purpose": "LOCATION",
            "city": "Decatur",
            "state": "GA",
            "postal_code": "300301644",
            "country_code": "US",
            "telephone_number": "404-251-2007",
            "fax_number": "404-371-9112",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EMORY PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-02-19",
        "last_updated": "2024-08-26",
        "certification_date": "2024-08-26",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "219-365-6560"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2024; 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.