Richard Edward Nyberg, P.T.

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

0897 Issued in GA

Practice address

2191 Northlake Pkwy
Suite 31
Tucker, GA 30084-4166

Phone

(770) 491-6004

Fax

(770) 723-0872

NPI assigned

Oct 4, 2007

Last updated

Oct 4, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

State University of New York Downstate Medical Center, 1975

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Atlanta Back Clinic - Orthopedic Phys Therapy and Training Ctr IncGroup PAC ID 5395711725, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Atlanta Back Clinic - Orthopedic Phys Therapy & Training Ctr Inc

  dba Atlanta Back Clinic Inc

  • Physical Therapist
  • Tucker, GA
  • NPI 1467676924
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1191456000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1191456000000",
    "number": "1366630345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2191 NORTHLAKE PKWY",
            "address_2": "SUITE 31",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844166",
            "telephone_number": "770-491-6004",
            "fax_number": "770-723-0872"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2191 NORTHLAKE PKWY",
            "address_2": "SUITE 31",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300844166",
            "telephone_number": "770-491-6004",
            "fax_number": "770-723-0872"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NYBERG",
        "first_name": "RICHARD",
        "middle_name": "EDWARD",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-10-04",
        "last_updated": "2007-10-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "GA",
            "license": "0897",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Hannah Nowland
• Noel Noya Pino
• Kristin Noyes, LCSW
• Nursing Care of Georgia (Comfort Keepers)
• Nutrition Consultants of Atlanta, LLC
• Frank Lynwood O'Connor Jr., D.D.S.
• Colleen Maria O'Donnell
• Occupational Health Centers of Georgia PC (Concentra Medical Center)
• Ocmulgee Medical Pathology Association Inc
• Ocmulgee Medical Pathology Association, Inc

• Orthopedic Physical Therapist in Tucker, GA
• Providers in Tucker, GA by specialty
• Orthopedic Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.