Individual provider Active NPI

Angie Brown, PT

  • Physical Therapist
  • Rincon, GA
National Provider Identifier
1437312410
Registry record updated Jul 9, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT009049 Issued in GA
Practice address
135 Goshen Road Ext
Ste 206
Rincon, GA 31326-5567
Phone
(912) 826-3797
Fax
(912) 826-9767
NPI assigned
Jul 9, 2008
Last updated
Jul 9, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2008

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 PT009049 GA Primary

Addresses

Primary practice location

135 Goshen Road Ext
Ste 206
Rincon, GA 31326-5567

Mailing address

135 Goshen Road Ext
Ste 206
Rincon, GA 31326-5567
Phone (912) 826-3797

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT009049GAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1437312410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "135 GOSHEN ROAD EXT",
            "address_2": "STE 206",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313265567",
            "telephone_number": "912-826-3797",
            "fax_number": "912-826-9767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "135 GOSHEN ROAD EXT",
            "address_2": "STE 206",
            "city": "RINCON",
            "state": "GA",
            "postal_code": "313265567",
            "telephone_number": "912-826-3797",
            "fax_number": "912-826-9767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROWN",
        "first_name": "ANGIE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT009049",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rincon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; 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.