Individual provider Active NPI

Patrick Ryan Reitz, PT

  • Physical Therapist
  • Roswell, GA
National Provider Identifier
1407113368
Registry record updated Apr 17, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT010589 Issued in GA
Practice address
1285 Hembree Rd
Suite 200D
Roswell, GA 30076-5720
Phone
(770) 772-5540
NPI assigned
Apr 17, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2012

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 PT010589 GA Primary

Addresses

Primary practice location

1285 Hembree Rd
Suite 200D
Roswell, GA 30076-5720

Mailing address

1285 Hembree Rd
Suite 200D
Roswell, GA 30076-5720
Phone (770) 772-5540

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
PT010589GAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1334620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334620800000",
    "number": "1407113368",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 HEMBREE RD",
            "address_2": "SUITE 200D",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765720",
            "telephone_number": "770-772-5540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 HEMBREE RD",
            "address_2": "SUITE 200D",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765720",
            "telephone_number": "770-772-5540"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REITZ",
        "first_name": "PATRICK",
        "middle_name": "RYAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-17",
        "last_updated": "2012-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT010589",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2012; 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.