Direct PT LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

DIRECT PT LLC

Practice address

902 Warnock Way
Woodstock, GA 30188-7073

Phone

(706) 340-3511

NPI assigned

Jul 16, 2024

Last updated

Jul 16, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Brent DavisNPI 1548784317

Title

Managing Member/Owner

Phone

(706) 340-3511

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 1

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.

• Brent Joseph Davis, PT, DPT

  • Physical Therapist
  • Woodstock, GA
  • NPI 1548784317
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1721088000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721088000000",
    "number": "1477391365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "902 WARNOCK WAY",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301887073"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "902 WARNOCK WAY",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301887073",
            "telephone_number": "706-340-3511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRECT PT LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-07-16",
        "last_updated": "2024-07-16",
        "certification_date": "2024-07-16",
        "status": "A",
        "authorized_official_last_name": "DAVIS",
        "authorized_official_first_name": "BRENT",
        "authorized_official_title_or_position": "MANAGING MEMBER/OWNER",
        "authorized_official_telephone_number": "706-340-3511"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tanya Dillon, PT, DPT
• Dimartino Family Chiropractic
• Robert Vincent Dimartino, D.C.
• Dimola Famiily Chiropractic Inc
• Anthony Dimola, DC
• Discover Rehabilitation, Inc
• Discover Wellness, LLC
• Shannon Kathleen Dobson, CPNP
• Karen Elizabeth Dodge, MS, APC, NCC
• Angelina Sarah Dodson

• Physical Therapist in Woodstock, GA
• Providers in Woodstock, 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 16, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.