Individual provider Active NPI

Michael Simmons

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1376126904
Registry record updated Mar 1, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT015275 Issued in GA
Practice address
1715 Howell Mill Rd NW Ste B2
Atlanta, GA 30318-3117
Phone
(404) 351-5432
NPI assigned
May 2, 2021
Last updated
Mar 1, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2022

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 PT015275 GA Primary
Physical Therapist 225100000X NU

Addresses

Primary practice location

1715 Howell Mill Rd NW Ste B2
Atlanta, GA 30318-3117

Mailing address

6397 Lee Hwy
Chattanooga, TN 37421-2564

Other practice location 1

1615 Ridenour Blvd NW Ste 204
Kennesaw, GA 30152-4464
Phone (770) 580-8070

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT015275GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy, Inc CurrentSince Feb 14, 2022 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Feb 14, 2022 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Feb 14, 2022 Accepting new patients
Atlanta South Physical Therapy, Inc Physical Therapist CurrentSince Feb 14, 2022 Accepting new patients
Drayer Physical Therapy Georgia LLC Physical Therapist CurrentSince Feb 14, 2022 Accepting new patients
PT Solutions of Acworth LLC Physical Therapist PastSince May 1, 2021 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1715 Howell Mill Rd NW
Ste B2
Atlanta, GA 30318
Phone (404) 351-5432

2255 Peachtree Rd NE
Ste G
Atlanta, GA 30309
Phone (404) 351-3257

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

3455 Highway 81
Loganville, GA 30052
Phone (678) 635-8280

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

Organizations & group practices 6

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": "1619913600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646092800000",
    "number": "1376126904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1715 HOWELL MILL RD NW STE B2",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303183117",
            "telephone_number": "404-351-5432"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1615 Ridenour Blvd NW Ste 204",
            "address_purpose": "LOCATION",
            "city": "Kennesaw",
            "state": "GA",
            "postal_code": "301524464",
            "country_code": "US",
            "telephone_number": "770-580-8070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "MICHAEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-02",
        "last_updated": "2022-03-01",
        "certification_date": "2022-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT015275",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "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 Mar 1, 2022; 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.