Individual provider Active NPI

Angelo J Rizzo, PT

  • Physical Therapist
  • Conyers, GA
National Provider Identifier
1316163975
Registry record updated Oct 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT001083 Issued in GA
Practice address
1157B West Ave SW
Conyers, GA 30012-5280
Phone
(770) 922-2420
Fax
(770) 922-1096
NPI assigned
Apr 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2022

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Physical Therapist 2251G0304X PT001083 GA
Sports Physical Therapist 2251S0007X PT001083 GA
Orthopedic Physical Therapist 2251X0800X PT001083 GA
Physical Therapist 225100000X PT001083 GA Primary

Addresses

Primary practice location

1157B West Ave SW
Conyers, GA 30012-5280

Mailing address

1650 Lyndon Farm CT Ste 300
Louisville, KY 40223-5005
Phone (572) 084-7317

Other identifiers 1

IdentifierTypeStateIssuer
460381266AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221206001749 GA Practitioner - Physical Therapist in Private Practice 5597787598 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT001083GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Human Performance and Rehabilitation Centers LLC CurrentSince Sep 1, 2022 Accepting new patients
Human Performance and Rehabilitation Centers, LLC Physical Therapist CurrentSince Sep 1, 2022 Accepting new patients
Human Performance and Rehabilitation Centers, LLC Physical Therapist Past Accepting new patients
Therapeutic Solutions, Inc Physical Therapist Past Accepting new patients

Locations

788 Prince Ave
Ste C
Athens, GA 30606
Phone (706) 453-2111

6298 Veterans Pkwy
Ste 5A
Columbus, GA 31909
Phone (706) 320-0927

1157 West Ave SW
#B
Conyers, GA 30012
Phone (770) 922-2120

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

Organizations & group practices 4

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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666224000000",
    "number": "1316163975",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "572-084-7317",
            "fax_number": "757-809-2370"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1157B WEST AVE SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300125280",
            "telephone_number": "770-922-2420",
            "fax_number": "770-922-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RIZZO",
        "first_name": "ANGELO",
        "middle_name": "J",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-18",
        "last_updated": "2022-10-20",
        "certification_date": "2022-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "GA",
            "license": "PT001083",
            "primary": false
        },
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "GA",
            "license": "PT001083",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "GA",
            "license": "PT001083",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT001083",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "460381266A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2022; 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.