NPIMap

Organization Active NPI

Independent Physical Therapy, LLC

Doing business as Benchmark PT

  • Physical Therapist
  • Stone Mountain, GA
National Provider Identifier
1447654058
Registry record updated Oct 24, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
INDEPENDENT PHYSICAL THERAPY, LLC
Doing business as
Benchmark PT
Practice address
1227 Rockbridge Rd Ste 212
Stone Mountain, GA 30087-3040
Phone
(770) 925-9210
Fax
(770) 925-7989
NPI assigned
Oct 11, 2014
Last updated
Oct 24, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 24, 2022

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

Authorized official

Name
Kevin Johanneson
Title
VP Revenue Cycle Manager
Phone
(423) 238-7217

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

1227 Rockbridge Rd Ste 212
Stone Mountain, GA 30087-3040

Mailing address

6397 Lee Hwy Ste 300
Chattanooga, TN 37421-2564
Phone (423) 238-7217

Other names 1

  • BENCHMARK PT Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Independent Phys Ther161 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

1227 Rockbridge Rd
Ste 402
Stone Mtn, GA 30087
Phone (770) 925-9210

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1412985600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1666569600000",
    "number": "1447654058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212564",
            "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": "1227 ROCKBRIDGE RD STE 212",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873040",
            "telephone_number": "770-925-9210",
            "fax_number": "770-925-7989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-11",
        "last_updated": "2022-10-24",
        "certification_date": "2022-10-24",
        "status": "A",
        "authorized_official_last_name": "JOHANNESON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "VP REVENUE CYCLE MANAGER",
        "authorized_official_telephone_number": "423-238-7217"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BENCHMARK PT",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BENCHMARK PT",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 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.