Michael J. Mansfield, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT011501 Issued in GA

Practice address

1765 Old West Broad St
Athens, GA 30606-2853

Phone

(706) 549-1663

Fax

(706) 546-8792

NPI assigned

Sep 19, 2014

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

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Pediatric Orthopedic Associates

  • Pediatric Radiology Physician
  • Salt Lake City, UT
  • NPI 1659488799
  NPD (past)

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

{
    "created_epoch": "1411084800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654646400000",
    "number": "1376945543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 OLD WEST BROAD ST",
            "address_2": "BLDG 2, STE 200",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062853",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1765 OLD WEST BROAD ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062853",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "705 Breedlove Dr Ste 200",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "GA",
            "postal_code": "306552080",
            "country_code": "US",
            "telephone_number": "770-554-5009",
            "fax_number": "706-546-8792",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3440 Highway 81",
            "address_purpose": "LOCATION",
            "city": "Loganville",
            "state": "GA",
            "postal_code": "300529112",
            "country_code": "US",
            "telephone_number": "770-554-5009",
            "fax_number": "706-546-8792",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1000 Cowles Clinc Way Ste A-400",
            "address_purpose": "LOCATION",
            "city": "Greensboro",
            "state": "GA",
            "postal_code": "306425289",
            "country_code": "US",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1553 Janmar Rd",
            "address_purpose": "LOCATION",
            "city": "Snellville",
            "state": "GA",
            "postal_code": "300785606",
            "country_code": "US",
            "telephone_number": "770-554-5009",
            "fax_number": "706-546-8792",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MANSFIELD",
        "first_name": "MICHAEL",
        "middle_name": "J.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-09-19",
        "last_updated": "2022-06-08",
        "certification_date": "2022-06-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011501",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH NUMBER",
            "identifier": "12798975",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Robert Jason Mann, NP
• Natosha Manning-Rollins, NP
• Katherine M Manning, LCSW
• Danielle Louise Manry, PT, DPT
• Jenny Mansfield, PT, DPT
• Aurelio D Manto, MD
• Kayla Addison Mapel, MSW
• Ian Marburger
• Christopher A March, M.D.
• Karrington Marcotte, RN

• Physical Therapist in Athens, GA
• Providers in Athens, GA by specialty
• Physical Therapist in Georgia

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