Individual provider Active NPI

Sally Ann Chapman Phillips, PT

  • Physical Therapist
  • Tucker, GA
National Provider Identifier
1316264997
Registry record updated Apr 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
000745 Issued in GA
Practice address
3760 Lavista Rd
Suite 102
Tucker, GA 30084-5615
Phone
(404) 248-0415
Fax
(404) 248-0422
NPI assigned
Apr 22, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2010

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 000745 GA Primary

Addresses

Primary practice location

3760 Lavista Rd
Suite 102
Tucker, GA 30084-5615

Mailing address

3760 Lavista Rd
Suite 102
Tucker, GA 30084-5615
Phone (404) 248-0415

Other identifiers 1

IdentifierTypeStateIssuer
000745OtherGAPT LICENSE NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
000745GAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1271894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1271894400000",
    "number": "1316264997",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 LAVISTA RD",
            "address_2": "SUITE 102",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845615",
            "telephone_number": "404-248-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3760 LAVISTA RD",
            "address_2": "SUITE 102",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300845615",
            "telephone_number": "404-248-0415",
            "fax_number": "404-248-0422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHAPMAN PHILLIPS",
        "first_name": "SALLY",
        "middle_name": "ANN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-22",
        "last_updated": "2010-04-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "000745",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE NUMBER",
            "identifier": "000745",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2010; 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.