NPIMap

Organization Active NPI

Pt360 Atl LLC

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1366110736
Registry record updated Aug 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PT360 ATL LLC
Practice address
4920 Roswell Rd Ste 36
Atlanta, GA 30342-2636
Phone
(404) 464-8300
Fax
(404) 464-8301
NPI assigned
Sep 1, 2021
Last updated
Aug 8, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2023

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

Authorized official

Name
Vikash SharmaNPI 1528356862
Title
Owner
Phone
(404) 464-8300

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: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

4920 Roswell Rd Ste 36
Atlanta, GA 30342-2636

Mailing address

4920 Roswell Rd Ste 36
Atlanta, GA 30342-2636
Phone (404) 464-8300

Other practice location 1

3400 Old Milton Pkwy Ste C390
Alpharetta, GA 30005-3714
Phone (404) 464-8300

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20211112000890 GA Part B Supplier - Clinic/Group Practice 6406245489 Receives reassigned benefits from 12 practitioners
Practice locations: Alpharetta, GA; Atlanta, GA

National Provider Directory

National Provider Directory

Locations

4920 Roswell Rd
Ste 36
Sandy Springs, GA 30342
Phone (404) 464-8300

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1630454400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691452800000",
    "number": "1366110736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4920 ROSWELL RD STE 36",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303422636",
            "telephone_number": "404-464-8300",
            "fax_number": "404-464-8301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4920 ROSWELL RD STE 36",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303422636",
            "telephone_number": "404-464-8300",
            "fax_number": "404-464-8301"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3400 Old Milton Pkwy Ste C390",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300053714",
            "country_code": "US",
            "telephone_number": "404-464-8300",
            "fax_number": "404-464-8301",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PT360 ATL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-01",
        "last_updated": "2023-08-08",
        "certification_date": "2023-08-08",
        "status": "A",
        "authorized_official_last_name": "SHARMA",
        "authorized_official_first_name": "VIKASH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-464-8300"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "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 Aug 8, 2023; 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.