NPIMap

Organization Active NPI

Excelarate Physical Therapy

  • Orthopedic Physical Therapist
  • Brunswick, GA
National Provider Identifier
1356818652
Registry record updated Oct 25, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
Legal business name
EXCELARATE PHYSICAL THERAPY
Practice address
216 Harrison LN
Brunswick, GA 31520-1959
Phone
(678) 699-4036
NPI assigned
Oct 25, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 25, 2018

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

Authorized official

Name
Dr. Sonya Denise RolandNPI 1265470355
Title
Owner - Physical Therapist
Phone
(678) 699-4036

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 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X
Geriatric Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251G0304X
Pediatric Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251P0200X
Orthopedic Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251X0800X Primary

Addresses

Primary practice location

216 Harrison LN
Brunswick, GA 31520-1959

Mailing address

216 Harrison LN
Brunswick, GA 31520-1959

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20181108001887 GA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2062766108 Receives reassigned benefits from 5 practitioners
Practice locations: Brunswick, GA

National Provider Directory

National Provider Directory

Locations

219 Harrison LN
Brunswick, GA 31520

216 Harrison Ln
Brunswick, GA 31520
Phone (912) 342-8982

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": "1540425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1540425600000",
    "number": "1356818652",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 HARRISON LN",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315201959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 HARRISON LN",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315201959",
            "telephone_number": "678-699-4036"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EXCELARATE PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-10-25",
        "last_updated": "2018-10-25",
        "status": "A",
        "authorized_official_last_name": "ROLAND",
        "authorized_official_first_name": "SONYA",
        "authorized_official_middle_name": "DENISE",
        "authorized_official_title_or_position": "OWNER - PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "678-699-4036",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Geriatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2018; 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.