NPIMap

Organization Active NPI

The Cantrell Center for Physical Therapy and Sports Medicine, P.C.

  • Physical Therapy Clinic/Center
  • Warner Robins, GA
National Provider Identifier
1417091372
Registry record updated May 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
225100000X Issued in GA
Legal business name
THE CANTRELL CENTER FOR PHYSICAL THERAPY AND SPORTS MEDICINE, P.C.
Practice address
405 Osigian Blvd
Warner Robins, GA 31088-8958
Phone
(478) 953-3535
NPI assigned
Feb 16, 2007
Last updated
May 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 30, 2008

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

Authorized official

Name
Mr. Michael G Cantrell Sr., MPTNPI 1861423451
Title
President and Co-Owner
Phone
(478) 953-3535

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 225100000X GA Primary

Addresses

Primary practice location

405 Osigian Blvd
Warner Robins, GA 31088-8958

Mailing address

405 Osigian Blvd
Warner Robins, GA 31088-8958
Phone (478) 953-3535

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040608000761 GA Part B Supplier - Clinic/Group Practice 9436132842 Receives reassigned benefits from 8 practitioners
Practice locations: Warner Robins, GA

National Provider Directory

National Provider Directory

Locations

281 Carl Vinson Pkwy
Ste I
Warner Robins, GA 31088
Phone (478) 329-9948

405 Osigian Blvd
Warner Robins, GA 31088
Phone (478) 953-3535

Practitioners & affiliated clinicians

Practitioners 17

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1212105600000",
    "number": "1417091372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "405 OSIGIAN BLVD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310888958",
            "telephone_number": "478-953-3535"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "405 OSIGIAN BLVD",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310888958",
            "telephone_number": "478-953-3535"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE CANTRELL CENTER FOR PHYSICAL THERAPY AND SPORTS MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2008-05-30",
        "status": "A",
        "authorized_official_last_name": "CANTRELL",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "PRESIDENT AND CO-OWNER",
        "authorized_official_telephone_number": "478-953-3535",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "Sr.",
        "authorized_official_credential": "MPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "GA",
            "license": "225100000X",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warner Robins, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2008; 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.