Individual provider Active NPI

Sydney Faith Schunk, PTA

  • Physical Therapy Assistant
  • Blue Ridge, GA
National Provider Identifier
1356041164
Registry record updated Mar 9, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
CP014955A Issued in GA
Practice address
990 E Main St Ste 7
Blue Ridge, GA 30513-4534
Phone
(706) 946-2035
Fax
(706) 946-2036
NPI assigned
Mar 9, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 9, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X A7959 NC
Physical Therapy Assistant 225200000X CP014955A GA Primary

Addresses

Primary practice location

990 E Main St Ste 7
Blue Ridge, GA 30513-4534

Mailing address

990 E Main St Ste 7
Blue Ridge, GA 30513-4534
Phone (706) 946-2035

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
CP014955AGAMDPhysical Therapy Assistant
A7959NCMDPhysical Therapy Assistant

NPI Registry JSON

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

{
    "created_epoch": "1678320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678320000000",
    "number": "1356041164",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "990 E MAIN ST STE 7",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305134534",
            "telephone_number": "706-946-2035",
            "fax_number": "706-946-2036"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 E MAIN ST STE 7",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305134534",
            "telephone_number": "706-946-2035",
            "fax_number": "706-946-2036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCHUNK",
        "first_name": "SYDNEY",
        "middle_name": "FAITH",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-09",
        "last_updated": "2023-03-09",
        "certification_date": "2023-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "NC",
            "license": "A7959",
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "CP014955A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Blue Ridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; 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.