Organization Active NPI

Therapy South Andalusia LLC

  • Physical Therapist
  • Andalusia, AL
National Provider Identifier
1306379797
Registry record updated Apr 4, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
102031 Issued in AL
Legal business name
THERAPY SOUTH ANDALUSIA LLC
Practice address
811 B West Bypass
Andalusia, AL 36420
Phone
(334) 222-2620
NPI assigned
Apr 4, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2017

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

Authorized official

Name
Stephen Foster
Title
President
Phone
(205) 745-3660

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 102031 AL Primary

Addresses

Primary practice location

811 B West Bypass
Andalusia, AL 36420

Mailing address

2823 Greystone Commercial Blvd
Birmingham, AL 35242-2660
Phone (205) 745-3660

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170801001994 AL Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0345511903 Receives reassigned benefits from 5 practitioners
Practice locations: Andalusia, AL

National Provider Directory

National Provider Directory

Locations

811 W Bypass
#B
Andalusia, AL 36420
Phone (334) 222-2620

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491264000000",
    "number": "1306379797",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2823 GREYSTONE COMMERCIAL BLVD",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352422660",
            "telephone_number": "205-745-3660",
            "fax_number": "205-745-3649"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 B WEST BYPASS",
            "city": "ANDALUSIA",
            "state": "AL",
            "postal_code": "36420",
            "telephone_number": "334-222-2620"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THERAPY SOUTH ANDALUSIA LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-04",
        "last_updated": "2017-04-04",
        "status": "A",
        "authorized_official_last_name": "FOSTER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "205-745-3660"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "102031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Andalusia, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 4, 2017; 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.