PT Four Kids LLC

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

PT002955 Issued in GA

Legal business name

PT FOUR KIDS LLC

Practice address

4458 Windsor Oaks Cir
Marietta, GA 30066-2320

Phone

(404) 509-9761

Fax

(678) 981-6336

NPI assigned

May 16, 2014

Organization subpart

No

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

Authorized official

Name

Susan H Mayne, PT

Title

Owner

Phone

(404) 509-9761

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• PT4KIDS Doing business as

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

{
    "created_epoch": "1400198400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1400198400000",
    "number": "1477964013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4458 WINDSOR OAKS CIR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300662320",
            "telephone_number": "404-509-9761",
            "fax_number": "678-981-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4458 WINDSOR OAKS CIR",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300662320",
            "telephone_number": "404-509-9761",
            "fax_number": "678-981-6336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PT FOUR KIDS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-05-16",
        "last_updated": "2014-05-16",
        "status": "A",
        "authorized_official_last_name": "MAYNE",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "H",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "404-509-9761",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "GA",
            "license": "PT002955",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000769315I",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "PT4KIDS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Psych Atlanta, P.C.
• Psychiatric Health Professionals, P.C.
• Psychological Affiliates
• Psychological Consultants of Marietta, PC
• Psychological Source, Inc.
• PT Solutions of Acworth, LLC
• PT Solutions of Acworth, LLC
• PT Solutions of Acworth, LLC
• Yi-Fei Pu, P.A.
• Publix Super Markets Inc

• Early Intervention Provider Agency in Marietta, GA
• Providers in Marietta, GA by specialty
• Early Intervention Provider Agency in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2014; 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.