Individual provider Active NPI

Laurie Traill, PT

  • Physical Therapist
  • Athens, GA
National Provider Identifier
1275213472
Registry record updated Jul 21, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT008224 Issued in GA
Practice address
801 Riverhill Dr
Athens, GA 30606-4067
Phone
(706) 369-7100
NPI assigned
Jul 21, 2023
Last updated
Jul 21, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT008224 GA Primary

Addresses

Primary practice location

801 Riverhill Dr
Athens, GA 30606-4067

Mailing address

1141 Southwind Dr
Bishop, GA 30621-1362
Phone (706) 614-9734

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050411001160 GA Practitioner - Physical Therapist in Private Practice 8527005685 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT008224GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Functional Pathways Preferred of Tennessee LLC Physical Therapist CurrentSince Jun 23, 2024 Accepting new patients
East Athens Physical Therapy Inc PastSince Mar 1, 2005 Accepting new patients

Locations

10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2847

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1689897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689897600000",
    "number": "1275213472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1141 SOUTHWIND DR",
            "city": "BISHOP",
            "state": "GA",
            "postal_code": "306211362",
            "telephone_number": "706-614-9734"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 RIVERHILL DR",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306064067",
            "telephone_number": "706-369-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRAILL",
        "first_name": "LAURIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-21",
        "last_updated": "2023-07-21",
        "certification_date": "2023-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008224",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2023; 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.