Individual provider Active NPI

Deborah Ann Corley, MPT

  • Physical Therapist
  • Augusta, GA
National Provider Identifier
1366637910
Registry record updated Sep 6, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT007717 Issued in GA
Practice address
817 Crawford Ave
Augusta, GA 30904-3772
Phone
(706) 736-1255
Fax
(706) 736-1258
NPI assigned
Sep 6, 2007
Last updated
Sep 6, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2007

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT007717 GA Primary
Physical Therapist 225100000X 4677 SC

Addresses

Primary practice location

817 Crawford Ave
Augusta, GA 30904-3772

Mailing address

817 Crawford Ave
Augusta, GA 30904-3772
Phone (706) 736-1255

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20191010002231 GA Practitioner - Physical Therapist in Private Practice 1951632652 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT007717GAMDPhysical Therapist
4677SCMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Maguire Therapy Services Inc. CurrentSince Apr 16, 2019 Accepting new patients
Proactive Rehabilitation & Wellness LLC Physical Therapist CurrentSince May 16, 2022 Accepting new patients
Functional Pathways Preferred of Tennessee LLC Physical Therapist CurrentSince Jul 1, 2021 Accepting new patients
Proactive Physical Therapy and Rehabilitation LLC Physical Therapist CurrentSince May 16, 2022 Accepting new patients
Neuro-Developmental Treatment Programs, Inc. Physical Therapist PastSince Oct 1, 2011 Accepting new patients

Locations

106 Pleasant Home Rd
Ste 2K
Augusta, GA 30907
Phone (706) 724-6543

2103 Reedale Ave
Augusta, GA 30906
Phone (706) 414-5058

10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2849

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1189036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189036800000",
    "number": "1366637910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "817 CRAWFORD AVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309043772",
            "telephone_number": "706-736-1255",
            "fax_number": "706-736-1258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "817 CRAWFORD AVE",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309043772",
            "telephone_number": "706-736-1255",
            "fax_number": "706-736-1258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CORLEY",
        "first_name": "DEBORAH",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-06",
        "last_updated": "2007-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT007717",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "4677",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2007; 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.