Individual provider Active NPI

Antonio T. Davis, MPT

  • Orthopedic Physical Therapist
  • Newnan, GA
National Provider Identifier
1477577484
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT007721 Issued in GA
Practice address
354 Newnan Crossing Byp
Suite 200
Newnan, GA 30265-2323
Phone
(770) 460-4747
Fax
(678) 673-5102
NPI assigned
Jul 26, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT007721 GA Primary

Addresses

Primary practice location

354 Newnan Crossing Byp
Suite 200
Newnan, GA 30265-2323

Mailing address

900 Circle 75 Pkwy SE
Suite 1700
Atlanta, GA 30339-3035
Phone (770) 953-6929

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130715000462 GA Practitioner - Physical Therapist in Private Practice 6406096411 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT007721GAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Associates Inc Current Accepting new patients
Emory Physical Therapy, LLC CurrentSince Jan 24, 2022 Accepting new patients
Emory Physical Therapy, LLC CurrentSince Jan 24, 2022 Accepting new patients
Physiotherapy Associates, Inc Orthopedic CurrentSince Oct 1, 2024 Accepting new patients
Physiotherapy Associates Inc CurrentSince Oct 1, 2024 Accepting new patients
Resurgens, LLC CurrentSince Aug 26, 2024 Accepting new patients
Emory Physical Therapy, LLC Current Accepting new patients
Resurgens, LLC CurrentSince Aug 26, 2024 Accepting new patients
Emory Physical Therapy, LLC Past Accepting new patients
Orthoatlanta, LLC Past Accepting new patients

Locations

21 Ortho Ln
Atlanta, GA 30329
Phone (404) 778-2516

1669 Phoenix Pkwy
Ste 102
College Park, GA 30349
Phone (770) 907-1023

1845 Satellite Blvd
Ste 750
Duluth, GA 30097
Phone (404) 778-6490

7813 Spivey Station Blvd
Ste 230
Jonesboro, GA 30236
Phone (404) 251-2458

758 Old Norcross Rd
Ste 175
Lawrenceville, GA 30046
Phone (770) 339-1387

966A Killian Hill Rd SW
Lilburn, GA 30047
Phone (770) 923-4815

156 Foster Dr
Ste B
McDonough, GA 30253
Phone (770) 506-4119

5671 Ptree Dunwoody Rd NE
Ste 700
Sandy Springs, GA 30342
Phone (404) 459-3732

5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590

Interoperability endpoints

  • Direct secure messaging: antonio.davis.1@15749.direct.athenahealth.com

Organizations & group practices 11

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.

NPI Registry JSON

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

{
    "created_epoch": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401753600000",
    "number": "1477577484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CIRCLE 75 PKWY SE",
            "address_2": "SUITE 1700",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393035",
            "telephone_number": "770-953-6929",
            "fax_number": "770-953-6972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "354 NEWNAN CROSSING BYP",
            "address_2": "SUITE 200",
            "city": "NEWNAN",
            "state": "GA",
            "postal_code": "302652323",
            "telephone_number": "770-460-4747",
            "fax_number": "678-673-5102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "ANTONIO",
        "middle_name": "T.",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-26",
        "last_updated": "2014-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "GA",
            "license": "PT007721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newnan, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; 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.