Organization Active NPI

Zona Physical Therapy, LLC

  • Physical Therapist
  • Suwanee, GA
National Provider Identifier
1518573872
Registry record updated Jul 21, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
ZONA PHYSICAL THERAPY, LLC
Practice address
302 Satellite Blvd NE Ste 111
Suwanee, GA 30024-7182
Phone
(862) 202-6596
NPI assigned
Sep 21, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2021

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

Authorized official

Name
Dr. Clarice Mbenyi Ezeanya, DPTNPI 1013253780
Title
Physical Therapist
Phone
(862) 202-6596

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

302 Satellite Blvd NE Ste 111
Suwanee, GA 30024-7182

Mailing address

302 Satellite Blvd NE Ste 111
Suwanee, GA 30024-7182
Phone (678) 765-0909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20201118000129 GA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 3375954605 Receives reassigned benefits from 1 practitioner
Practice locations: Buford, GA

National Provider Directory

National Provider Directory

Locations

302 Satellite Blvd NE
Ste 111
Suwanee, GA 30024
Phone (678) 765-0909

Practitioners & affiliated clinicians

Practitioners 1

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": "1600646400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1626825600000",
    "number": "1518573872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "302 SATELLITE BLVD NE STE 111",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300247182",
            "telephone_number": "678-765-0909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "302 SATELLITE BLVD NE STE 111",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300247182",
            "telephone_number": "862-202-6596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZONA PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-21",
        "last_updated": "2021-07-21",
        "certification_date": "2021-07-21",
        "status": "A",
        "authorized_official_last_name": "EZEANYA",
        "authorized_official_first_name": "CLARICE",
        "authorized_official_middle_name": "MBENYI",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "862-202-6596",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.