Individual provider Active NPI

Tony A Roberts, PT, DPT

  • Physical Therapist
  • Locust Grove, GA
National Provider Identifier
1285090548
Registry record updated Apr 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT014557 Issued in GA
Practice address
4959 Bill Gardner Pkwy Ste 109
Locust Grove, GA 30248-2915
Phone
(770) 914-9285
Fax
(770) 914-5668
NPI assigned
Jan 1, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2021

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT30071 FL
Physical Therapist 225100000X PT014557 GA Primary

Addresses

Primary practice location

4959 Bill Gardner Pkwy Ste 109
Locust Grove, GA 30248-2915

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Other practice location 1

196 Scottville Rd
LaMont, FL 32336-7310
Phone (850) 345-4274

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA, FL2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200727001071 GA Practitioner - Physical Therapist in Private Practice 0941536742 Reassigns benefits to 3 organizations
I20241028001836 FL Practitioner - Physical Therapist in Private Practice 0941536742 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Randr Physical Therapy Inc.Group PAC ID 4789586660, 3 clinicians

Practice addresses (Care Compare)

1660 N Monroe St
Suite 3
Tallahassee, FL 32303-5558
Phone (850) 656-3163

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
PT014557GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Mar 22, 2021 Accepting new patients
Benchmark Physical Therapy, Inc CurrentSince Mar 22, 2021 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Mar 22, 2021 Accepting new patients
R&R Physical Therapy Inc. Physical Therapist CurrentSince Jul 16, 2024 Accepting new patients
Atlanta South Physical Therapy, Inc Physical Therapist CurrentSince Mar 22, 2021 Accepting new patients
Drayer Physical Therapy Georgia LLC Physical Therapist CurrentSince Mar 22, 2021 Accepting new patients
Burke Collins Therapy, Inc Physical Therapist CurrentSince Sep 1, 2025 Accepting new patients
Physical Therapy Now Holdings, LLC Physical Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

3339 Highway 17
Green Cove Springs, FL 32043
Phone (904) 284-5721

1660 N Monroe St
Ste 3
Tallahassee, FL 32303
Phone (850) 656-3163

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

4959 Bill Gardner Pkwy
Ste 109
Locust Grove, GA 30248
Phone (770) 914-9285

3455 Highway 81
Loganville, GA 30052
Phone (678) 635-8280

1498 Hudson Bridge Rd
Stockbridge, GA 30281
Phone (678) 289-0525

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1451606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619395200000",
    "number": "1285090548",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "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": "4959 BILL GARDNER PKWY STE 109",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302482915",
            "telephone_number": "770-914-9285",
            "fax_number": "770-914-5668"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "196 Scottville Rd",
            "address_purpose": "LOCATION",
            "city": "LaMont",
            "state": "FL",
            "postal_code": "323367310",
            "country_code": "US",
            "telephone_number": "850-345-4274",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "TONY",
        "middle_name": "A",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-01-01",
        "last_updated": "2021-04-26",
        "certification_date": "2021-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT30071",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Locust Grove, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.