Individual provider Active NPI

Philip Kiszie, PT

  • Physical Therapist
  • Rome, GA
National Provider Identifier
1497751697
Registry record updated Oct 22, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT008028 Issued in GA
Practice address
201 Turner McCall Blvd NW
Rome, GA 30165-2545
Phone
(706) 236-2758
Fax
(706) 802-1408
NPI assigned
Jun 22, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT008028 GA Primary

Addresses

Primary practice location

201 Turner McCall Blvd NW
Rome, GA 30165-2545

Mailing address

PO Box 949
Rome, GA 30162-0949
Phone (706) 236-2758

Other identifiers 1

IdentifierTypeStateIssuer
P00319889OtherGARR MEDICARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051202000267 GA Practitioner - Physical Therapist in Private Practice 6204856495 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Horizons Therapy Group, Inc.Group PAC ID 5496781627, 12 clinicians

Practice addresses (Care Compare)

258 Woodfall Rd
Cedartown, GA 30125-5904
Phone (678) 472-4042

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Physical Therapy, LLC CurrentSince Dec 27, 2021 Accepting new patients
Horizons Therapy Group, Inc. Physical Therapist CurrentSince May 1, 2023 Accepting new patients
Emory Physical Therapy, LLC CurrentSince Dec 27, 2021 Accepting new patients
Emory Physical Therapy, LLC Current Accepting new patients
Advance Rehabilitation & Consulting Limited Partnership Physical Therapist Past Accepting new patients

Locations

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

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

Organizations & group practices 5

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": "1119398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193011200000",
    "number": "1497751697",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 949",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301620949",
            "telephone_number": "706-236-2758",
            "fax_number": "706-802-1408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "201 TURNER MCCALL BLVD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652545",
            "telephone_number": "706-236-2758",
            "fax_number": "706-802-1408"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISZIE",
        "first_name": "PHILIP",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-22",
        "last_updated": "2007-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P00319889",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.