Physio-Care, Inc

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

6750 Issued in GA

Legal business name

PHYSIO-CARE, INC

Practice address

605 Castlebar Way
McDonough, GA 30253-4786

Phone

(678) 523-8722

Fax

(678) 583-0855

NPI assigned

Dec 10, 2008

Organization subpart

No

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

Authorized official

Name

Remi Durojaiye

Title

Owner

Phone

(678) 523-8722

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228867200000",
    "number": "1508001116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "605 CASTLEBAR WAY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "605 CASTLEBAR WAY",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302534786",
            "telephone_number": "678-523-8722",
            "fax_number": "678-583-0855"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIO-CARE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-10",
        "last_updated": "2008-12-10",
        "status": "A",
        "authorized_official_last_name": "DUROJAIYE",
        "authorized_official_first_name": "REMI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "678-523-8722"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "GA",
            "license": "6750",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2008; 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.