Wesley Adam Spake, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT010334 Issued in GA

Practice address

455 Philip Blvd BLDG 100
Ste. 160
Lawrenceville, GA 30046-8767

Phone

(678) 985-0238

NPI assigned

Jul 5, 2011

Last updated

Jul 23, 2020By the provider in NPPES

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Atlanta South Physical Therapy, Inc

  dba Rehab South

  • Physical Therapist
  • Lawrenceville, GA
  • NPI 1922051564
  NPD
• Benchmark Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Duluth, GA
  • NPI 1083666903
  NPD
• Drayer Physical Therapy Georgia LLC

  • Physical Therapist
  • Loganville, GA
  • NPI 1962830406
  NPD
• Independent Physical Therapy of Ga, LLC

  • Physical Therapy Clinic/Center
  • Suwanee, GA
  • NPI 1396058814
  NPD
• Independent Physical Therapy of Georgia, LLC

  dba Benchmark PT

  • Occupational Therapist
  • Gainesville, GA
  • NPI 1306013941

  Physical Therapist

  NPD
• Independent Physical Therapy of Georgia, LLC

  dba BenchMark Physical Therapy

  • Physical Therapist
  • Fort Oglethorpe, GA
  • NPI 1780636068
  NPD
• Drayer Physical Therapy Georgia LLC

  • Physical Therapist
  • Monroe, GA
  • NPI 1568890382
  NPD (past)

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

{
    "created_epoch": "1309824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1595462400000",
    "number": "1427345081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 PHILIP BLVD BLDG 100",
            "address_2": "STE. 160",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468767",
            "telephone_number": "678-985-0238"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1221 W Spring St",
            "address_purpose": "LOCATION",
            "city": "Monroe",
            "state": "GA",
            "postal_code": "306551756",
            "country_code": "US",
            "telephone_number": "770-207-6624",
            "fax_number": "678-392-2703",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SPAKE",
        "first_name": "WESLEY",
        "middle_name": "ADAM",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-07-05",
        "last_updated": "2020-07-23",
        "certification_date": "2020-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT010334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sovereign Rehabilitation of Georgia, LLC (Centers for Orthopedic Rehab)
• Yacine N Sow, MD
• Emmanuel O Soyoola, M.D., PHD
• Vyacheslav Vladimirovich Sozonov, DNAP
• Jordan Spain
• Kea Reshun Sparkman, LPC
• Alyssa Sparks, RBT
• Amanda Spearman
• Debra Ann Spears, DO
• Jenna Spears

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2020; 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.