Professional Therapy Services, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PROFESSIONAL THERAPY SERVICES, LLC

Doing business as

Pro Therapy

Practice address

1100 Sherwood Park Dr NE Ste 140
Gainesville, GA 30501-3426

Phone

(770) 297-7750

Fax

(770) 297-1026

NPI assigned

Sep 5, 2006

Last updated

Apr 26, 2012By 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

Troy BageNPI 1679650824

Title

President

Phone

(423) 238-7217

Specialties & licenses 4

Addresses

Other names 1

• Pro Therapy Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1275635625. Details of each certification follow.

• CCN 116807 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 116807

Legal name

PROFESSIONAL THERAPY SERVICES

Certification status

Active

Provider type (POS)

Outpatient physical therapy / speech pathology

Participating since

Jun 24, 1999

Last certification

Aug 4, 2014

Ownership / control type

Proprietary

Facility address

1100 Sherwood Park Drive Suite 140
Gainesville, GA 30501

Practitioners 1

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.

• Troy Dale Bage, PT

  • Physical Therapist
  • Ooltewah, TN
  • NPI 1679650824
  Authorized official Same address or phone

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

{
    "created_epoch": "1157414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1335398400000",
    "number": "1275635625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 SHERWOOD PARK DR NE STE 140",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013426",
            "telephone_number": "770-297-7750",
            "fax_number": "770-297-1026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL THERAPY SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-05",
        "last_updated": "2012-04-26",
        "status": "A",
        "authorized_official_last_name": "BAGE",
        "authorized_official_first_name": "TROY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "423-238-7217"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XE1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Ergonomics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225XH1200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist, Hand",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pro Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Jordan Pruitt, PA
• Kristen Agnew Pruitt, M.S, PT
• Lisa Carol Pruitt, LPN

• Physical Therapist in Gainesville, GA
• Providers in Gainesville, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.