Individual provider Active NPI

George Brent Applegate, MPT

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1306970629
Registry record updated Dec 29, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT007063 Issued in GA
Practice address
4371 Powers Ferry Rd
Atlanta, GA 30327-3420
Phone
(678) 984-7774
Fax
(888) 551-6210
NPI assigned
Mar 16, 2007
Last updated
Dec 29, 2016By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2016

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 PT007063 GA Primary

Addresses

Primary practice location

4371 Powers Ferry Rd
Atlanta, GA 30327-3420

Mailing address

316 S Washington Ave
Fort Collins, CO 80521-2559
Phone (678) 984-7774

Other identifiers 2

IdentifierTypeStateIssuer
52704274OtherGABCBS OF GA PROVIDER ID
148541482BMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250513001116 CO Practitioner - Physical Therapist in Private Practice 1153603014 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

725 S Overland Trail
Fort Collins, CO 80523-1669
Phone (970) 491-1651

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Organizations & group practices 1

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": "1174003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1482969600000",
    "number": "1306970629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "316 S WASHINGTON AVE",
            "city": "FORT COLLINS",
            "state": "CO",
            "postal_code": "805212559",
            "telephone_number": "678-984-7774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4371 POWERS FERRY RD",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303273420",
            "telephone_number": "678-984-7774",
            "fax_number": "888-551-6210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "APPLEGATE",
        "first_name": "GEORGE",
        "middle_name": "BRENT",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-16",
        "last_updated": "2016-12-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT007063",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS OF GA PROVIDER ID",
            "identifier": "52704274",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "148541482B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2016; 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.