Individual provider Active NPI

Joseph Powell

  • Physical Therapist
  • McDonough, GA
National Provider Identifier
1376612192
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
50 Lawrenceville St Ste 103
McDonough, GA 30253-2351
Phone
(770) 898-5401
NPI assigned
Nov 7, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

50 Lawrenceville St Ste 103
McDonough, GA 30253-2351

Mailing address

4522 Westminster Dr
Ellenwood, GA 30294-3795
Phone (678) 565-8164

Other identifiers 1

IdentifierTypeStateIssuer
007482OtherGALICENSE#

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070720000496 GA Practitioner - Physical Therapist in Private Practice 2365447984 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1151 Nortec Dr SE
Suite a
Conyers, GA 30013-5834
Phone (470) 276-6449

2200 Hwy 155 N
Suite 130
McDonough, GA 30252-4846
Phone (770) 320-7840

Merit-based Incentive Payment System (MIPS)

Final score
28.44 of 100Reported as individual
Quality
13.33
Improvement activities
0
Cost
77.02

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Proactive Rehab, Inc Physical Therapist CurrentSince Sep 14, 2011 Accepting new patients
Middle Georgia Family Rehab CurrentSince Jun 22, 2020 Accepting new patients
Joseph Powell PastSince Jul 16, 2007 Accepting new patients

Locations

100 Hamilton Pointe Dr
Ste 115
Byron, GA 31008
Phone (478) 956-4916

1151 Nortec Dr SE
Ste A
Conyers, GA 30013
Phone (470) 276-6449

2200 Highway 155 N
Ste 130
McDonough, GA 30252
Phone (770) 320-7840

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/12689/brand/1/csg/1/fhir/r4

Organizations & group practices 3

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": "1162857600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1376612192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4522 WESTMINSTER DR",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302943795",
            "telephone_number": "678-565-8164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 LAWRENCEVILLE ST STE 103",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302532351",
            "telephone_number": "770-898-5401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "JOSEPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE#",
            "identifier": "007482",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in McDonough, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.