Active NPI
Justin Randall Stewart, PT
- Physical Therapist
- Buford, GA
National Provider Identifier
1265762496
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9849
- Practice address
- 3919 Carter Rd
Buford, GA 30518-1628 - Phone
- (706) 614-5772
- Fax
- (770) 614-5991
- NPI assigned
- Jan 11, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 9849 | GA | Primary |
Addresses
Primary practice location
3919 Carter Rd
Buford, GA 30518-1628
Mailing address
1251 Founders Lake Dr
Athens, GA 30606-7645
Phone (706) 614-5772
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9849 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| East Athens Physical Therapy Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapy Clinic/Center
- Athens, GA
- NPI 1326082611
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1263168000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263168000000",
"number": "1265762496",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1251 FOUNDERS LAKE DR",
"city": "ATHENS",
"state": "GA",
"postal_code": "306067645",
"telephone_number": "706-614-5772"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3919 CARTER RD",
"city": "BUFORD",
"state": "GA",
"postal_code": "305181628",
"telephone_number": "706-614-5772",
"fax_number": "770-614-5991"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STEWART",
"first_name": "JUSTIN",
"middle_name": "RANDALL",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-01-11",
"last_updated": "2010-01-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "9849",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Buford, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.