NPIMap

Organization Active NPI

Intown Physical Therapy, LLC

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1346683588
Registry record updated Jul 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT010150 Issued in GA
Legal business name
INTOWN PHYSICAL THERAPY, LLC
Practice address
495 Moreland Ave SE Ste B
Atlanta, GA 30316-1552
Phone
(404) 883-2204
Fax
(404) 393-3270
NPI assigned
Apr 8, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2021

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

Authorized official

Name
Dr. Ingrid A Anderson, PT, DPTNPI 1235431396
Title
Owner
Phone
(404) 883-2304

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT010150 GA Primary

Addresses

Primary practice location

495 Moreland Ave SE Ste B
Atlanta, GA 30316-1552

Mailing address

495 Moreland Ave SE Ste B
Atlanta, GA 30316-1552
Phone (404) 883-2204

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130821000342 GA Part B Supplier - Clinic/Group Practice 4688817703 Receives reassigned benefits from 4 practitioners
Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory

Locations

495 Moreland Ave SE
Ste B
Atlanta, GA 30316
Phone (404) 883-2204

619 Edgewood Ave SE
Ste T103
Atlanta, GA 30312
Phone (404) 883-2204

Practitioners & affiliated clinicians

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1365379200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1625616000000",
    "number": "1346683588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "495 MORELAND AVE SE STE B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303161552",
            "telephone_number": "404-883-2204",
            "fax_number": "404-393-3270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 MORELAND AVE SE STE B",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303161552",
            "telephone_number": "404-883-2204",
            "fax_number": "404-393-3270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTOWN PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-08",
        "last_updated": "2021-07-07",
        "certification_date": "2021-07-07",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "INGRID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-883-2304",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT010150",
            "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 Jul 7, 2021; 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.