Individual provider Active NPI

Molly Marie McKay, M.P.T.

  • Physical Therapist
  • Augusta, GA
National Provider Identifier
1518035658
Registry record updated Jun 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
011743 Issued in GA
Practice address
1441 Reynolds St
Augusta, GA 30901-1048
Phone
(706) 922-6550
Fax
(706) 922-5330
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1139509 TX
Physical Therapist 225100000X 011743 GA Primary

Addresses

Primary practice location

1441 Reynolds St
Augusta, GA 30901-1048

Mailing address

2520 Associates Way
Evans, GA 30809-3106
Phone (706) 922-6550

Other identifiers 4

IdentifierTypeStateIssuer
6362783OtherTXCIGNA
8T1934OtherTXBLUE CROSS BLUE SHIELD
2073319OtherTXFIRST HEALTH CCN
7615482OtherTXAETNA

Other names 1

  • Molly Marie Brunson Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150309000072 GA Practitioner - Physical Therapist in Private Practice 2264415488 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peak Rehabilitation, Fitness and Performance CenterGroup PAC ID 3971653064, 12 clinicians

Practice addresses (Care Compare)

1441 Reynolds St
Augusta, GA 30901-1048
Phone (706) 823-3807

2520 Associates Way
Evans, GA 30809-3106
Phone (706) 922-6550

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011743GAMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Peak Rehabilitation, Fitness and Performance Center Physical Therapist CurrentSince Nov 18, 2014 Accepting new patients
Temple Builders, LLC Current Accepting new patients
Caba Therapy Services Physical Therapist Past Accepting new patients

Locations

1305 Dantignac St
Augusta, GA 30901
Phone (706) 823-2807

1441 Reynolds St
Augusta, GA 30901
Phone (706) 823-3807

1305 Dantignac St
#D
Augusta, GA 30901
Phone (706) 823-3807

2520 Associates Way
Evans, GA 30809
Phone (706) 823-3807

Organizations & group practices 3

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718236800000",
    "number": "1518035658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2520 ASSOCIATES WAY",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308093106",
            "telephone_number": "706-922-6550",
            "fax_number": "706-922-5330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1441 REYNOLDS ST",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309011048",
            "telephone_number": "706-922-6550",
            "fax_number": "706-922-5330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCKAY",
        "first_name": "MOLLY",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.P.T.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2024-06-13",
        "certification_date": "2024-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1139509",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "011743",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "6362783",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "8T1934",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH CCN",
            "identifier": "2073319",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7615482",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MOLLY",
            "last_name": "BRUNSON",
            "middle_name": "MARIE",
            "credential": "M.P.T.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2024; 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.