NPIMap

Organization Active NPI

Prosper Perfromance & Physical Therapy

  • Physical Therapy Clinic/Center
  • Suwanee, GA
National Provider Identifier
1467984559
Registry record updated Mar 29, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
008313 Issued in GA
Legal business name
PROSPER PERFROMANCE & PHYSICAL THERAPY
Practice address
560 Old Peachtree Rd NW
Suite 200
Suwanee, GA 30024-7275
Phone
(478) 987-9697
NPI assigned
Mar 29, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 29, 2017

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

Authorized official

Name
Kristen Spencer
Title
Owner/Clinical Operations Manager
Phone
(478) 987-9697

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 008313 GA Primary

Addresses

Primary practice location

560 Old Peachtree Rd NW
Suite 200
Suwanee, GA 30024-7275

Mailing address

560 Old Peachtree Rd NW
Suite 200
Suwanee, GA 30024-7275
Phone (478) 987-9697

National Provider Directory

National Provider Directory

Locations

560 Old Peachtree Rd NW
Ste 200
Suwanee, GA 30024
Phone (478) 987-9697

NPI Registry JSON

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

{
    "created_epoch": "1490745600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1490745600000",
    "number": "1467984559",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "560 OLD PEACHTREE RD NW",
            "address_2": "SUITE 200",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300247275",
            "telephone_number": "478-987-9697"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "560 OLD PEACHTREE RD NW",
            "address_2": "SUITE 200",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300247275",
            "telephone_number": "478-987-9697"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROSPER PERFROMANCE & PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-03-29",
        "last_updated": "2017-03-29",
        "status": "A",
        "authorized_official_last_name": "SPENCER",
        "authorized_official_first_name": "KRISTEN",
        "authorized_official_title_or_position": "OWNER/CLINICAL OPERATIONS MANAGER",
        "authorized_official_telephone_number": "478-987-9697"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "GA",
            "license": "008313",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; 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.