Marissa Danielle Hagenbruch, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

CP060297T Issued in GA

Practice address

1390 Boone Avenue Ext Ste 23
Kingsland, GA 31548-6516

Phone

(912) 319-0400

NPI assigned

Aug 2, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in NC, VA2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Emergeortho PAGroup PAC ID 0749188894, 726 clinicians

Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians

Ivyrehab Sept, LLCGroup PAC ID 7911990908, 216 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: marissa.hagenbruch.1@847.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Agilitas USA Inc

  dba Results Physiotherapy

  • Physical Therapy Clinic/Center
  • Hixson, TN
  • NPI 1962417444

  NC, Physical Therapist

  Medicare reassignment Care Compare group NPD
• Emergeortho PA

  • Orthopaedic Surgery Physician
  • Durham, NC
  • NPI 1376592964

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Ivyrehab Sept, LLC

  • Physical Therapist
  • Virginia Beach, VA
  • NPI 1982657433
  Medicare reassignment Care Compare group NPD
• Benchmark Physical Therapy of North Carolina LLC

  • Physical Therapist
  • Ooltewah, TN
  • NPI 1356894604

  NC

  Medicare reassignment
• Drayer Physical Therapy of North Carolina LLC

  • Physical Therapist
  • Raleigh, NC
  • NPI 1740605096
  Medicare reassignment
• Physical Therapy and Hand Specialists, LLC

  • Physical Therapist
  • Greensboro, NC
  • NPI 1518382357
  Medicare reassignment
• Agilitas USA, Inc

  dba Results Physiotherapy

  • Physical Therapy Clinic/Center
  • Chattanooga, TN
  • NPI 1518695436

  Physical Therapist

  NPD
• Emergeortho PA

  • Durable Medical Equipment & Medical Supplies
  • Eden, NC
  • NPI 1841170222
  NPD
• Ivyrehab Sept, LLC

  • Physical Medicine & Rehabilitation Physician
  • Verona, VA
  • NPI 1235955709

  Physical Therapist

  NPD

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

{
    "created_epoch": "1659398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1785024000000",
    "number": "1467189357",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1390 BOONE AVENUE EXT STE 23",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486516",
            "telephone_number": "912-319-0400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 BOONE AVENUE EXT STE 23",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486516",
            "telephone_number": "912-319-0400"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2145 Country Club Rd Ste 200",
            "address_purpose": "LOCATION",
            "city": "Jacksonville",
            "state": "NC",
            "postal_code": "285462404",
            "country_code": "US",
            "telephone_number": "252-726-1802",
            "fax_number": "252-726-1805",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "245 E Nc Highway 54 Ste 103",
            "address_purpose": "LOCATION",
            "city": "Durham",
            "state": "NC",
            "postal_code": "277132552",
            "country_code": "US",
            "telephone_number": "919-907-3103",
            "fax_number": "919-907-3104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "911 B St STE 102",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233242462",
            "country_code": "US",
            "telephone_number": "757-548-0014",
            "fax_number": "757-351-1930",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HAGENBRUCH",
        "first_name": "MARISSA",
        "middle_name": "DANIELLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-02",
        "last_updated": "2026-07-26",
        "certification_date": "2026-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "CP060297T",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "CP051288T",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P21503",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kimberly Michelle Gomez, MSN, APRN, FNP-C
• Samantha Graf
• Kimberly H Graw, APRN, BC, FNP
• Briana Gray
• Shilliane M Green
• Barbara Ann Hahn, CRNA
• Paige B Hand, LPC, NCC
• Charles M Harden Jr., MD
• Marisa G Harvey, PT
• Heartland EMS Inc

• Physical Therapist in Kingsland, GA
• Providers in Kingsland, 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 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.