NPIMap

Organization Active NPI

North Georgia Therapy for Kids, LLC

  • Physical Therapy Clinic/Center
  • Cumming, GA
National Provider Identifier
1487073904
Registry record updated Apr 11, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
GA OT 004063 Issued in GA
Legal business name
NORTH GEORGIA THERAPY FOR KIDS, LLC
Practice address
4655 Dahlonega Hwy
Cumming, GA 30028-3304
Phone
(678) 780-6941
NPI assigned
Apr 11, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2014

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

Authorized official

Name
Amy Wallace, OT, CHT
Title
Ceo/Owner
Phone
(678) 780-6941

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X GA OT 004063 GA Primary

Addresses

Primary practice location

4655 Dahlonega Hwy
Cumming, GA 30028-3304

Mailing address

4655 Dahlonega Hwy
Cumming, GA 30028
Phone (678) 780-6941

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1397174400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397174400000",
    "number": "1487073904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4655 DAHLONEGA HWY",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "30028",
            "telephone_number": "678-780-6941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4655 DAHLONEGA HWY",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300283304",
            "telephone_number": "678-780-6941"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTH GEORGIA THERAPY FOR KIDS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-04-11",
        "last_updated": "2014-04-11",
        "status": "A",
        "authorized_official_last_name": "WALLACE",
        "authorized_official_first_name": "AMY",
        "authorized_official_title_or_position": "CEO/OWNER",
        "authorized_official_telephone_number": "678-780-6941",
        "authorized_official_credential": "OT, CHT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "GA",
            "license": "GA  OT 004063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 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.