Complete Body Wellness Studio, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

COMPLETE BODY WELLNESS STUDIO, LLC

Practice address

11805 Northfall LN Ste 804
Alpharetta, GA 30009-7970

Phone

(770) 712-5955

Fax

(770) 889-0244

NPI assigned

Sep 11, 2017

Last updated

Sep 11, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ginger Lee Carr, PT

Title

Owner/Physical Therapist

Phone

(770) 712-5955

Specialties & licenses 3

Addresses

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

{
    "created_epoch": "1505088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1505088000000",
    "number": "1265951289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 MILLERS CT",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300042515",
            "telephone_number": "770-712-5955",
            "fax_number": "770-889-0244"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11805 NORTHFALL LN STE 804",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300097970",
            "telephone_number": "770-712-5955",
            "fax_number": "770-889-0244"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMPLETE BODY WELLNESS STUDIO, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-11",
        "last_updated": "2017-09-11",
        "status": "A",
        "authorized_official_last_name": "CARR",
        "authorized_official_first_name": "GINGER",
        "authorized_official_middle_name": "LEE",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "770-712-5955",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2017; 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.