Physicollective LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PHYSICOLLECTIVE LLC

Practice address

8735 Dunwoody PL # 4921
Atlanta, GA 30350-2995

Phone

(404) 465-2642

NPI assigned

Aug 29, 2024

Organization subpart

No

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

Authorized official

Name

Ericka Wigfall, DPT

Title

Owner

Phone

(404) 465-2642

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1724889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1306670591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8735 DUNWOODY PL # 4921",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303502995",
            "telephone_number": "404-465-2642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8735 DUNWOODY PL # 4921",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303502995",
            "telephone_number": "404-465-2642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICOLLECTIVE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-08-29",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A",
        "authorized_official_last_name": "WIGFALL",
        "authorized_official_first_name": "ERICKA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-465-2642",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Atlanta, GA
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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 2024; 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.