Independent Physical Therapy of Georgia, LLC

Organization Active NPI Physical Therapy Clinic/Center · Trenton, GA

NPI 1508150640 · NPPES record last updated Jun 7, 2011

Key facts

NPI
1508150640
Entity type
Organization (NPI type 2)
Primary specialty
Physical Therapy Clinic/Center 261QP2000X
Legal business name
INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC
Practice address
5395 Highway 136
Trenton, GA 30752-2900
Phone
(423) 238-7217
NPI assigned
Jun 7, 2011
Organization subpart
No

Authorized official

Name
Troy D Bage
Title
President
Phone
(423) 238-7217

Other NPIs on the same Medicare enrollment 35

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 35

Corporate family (same tax ID) 24

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 1

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

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040303000396 GA Part B Supplier - Clinic/Group Practice 2961312244 Receives reassigned benefits from 1,039 practitioners
35 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment

National Provider Directory

Tax ID family
Independent Physical TH (161 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X
Physical Therapy Clinic/Center 261QP2000X Yes
Rehabilitation Clinic/Center 261QR0400X

Addresses

Primary practice location

5395 Highway 136
Trenton, GA 30752-2900

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

Other names

  • BenchMark PT Other name

Other providers in Trenton, GA

All providers in Trenton, GA · Physical Therapy Clinic/Center in Georgia

Sources for this page

Verify at the official NPI Registry.