Individual provider Active NPI

Nazario Maglanque II, PT

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1336784909
Registry record updated Nov 7, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT011784 Issued in GA
Practice address
275 Carpenter Dr Ste 210
Atlanta, GA 30328-4910
Phone
(404) 565-2266
Fax
(866) 929-8332
NPI assigned
Nov 7, 2019
Last updated
Nov 7, 2019By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 7, 2019

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 PT011784 GA Primary

Addresses

Primary practice location

275 Carpenter Dr Ste 210
Atlanta, GA 30328-4910

Mailing address

275 Carpenter Dr Ste 210
Atlanta, GA 30328-4910
Phone (404) 565-2266

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Orthoatlanta, LLC CurrentSince Feb 3, 2020 Accepting new patients
Orthoatlanta, LLC CurrentSince Feb 3, 2020 Accepting new patients
Orthoatlanta, LLC Current Accepting new patients

Locations

1265 Highway 54 W
Ste 308
Fayetteville, GA 30214
Phone (678) 216-0771

620 Cherokee St NE
Ste 300
Marietta, GA 30060
Phone (770) 635-1812

354 Newnan Crossing Byp
Ste 200
Newnan, GA 30265
Phone (770) 460-1900

Organizations & group practices 3

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": "1573084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573084800000",
    "number": "1336784909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 CARPENTER DR STE 210",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284910",
            "telephone_number": "404-565-2266",
            "fax_number": "866-929-8332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 CARPENTER DR STE 210",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303284910",
            "telephone_number": "404-565-2266",
            "fax_number": "866-929-8332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAGLANQUE",
        "first_name": "NAZARIO",
        "name_prefix": "Mr.",
        "name_suffix": "II",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-11-07",
        "last_updated": "2019-11-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011784",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Nov 7, 2019; 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.