Somatic Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

SOMATIC PHYSICAL THERAPY LLC

Practice address

210 South St
Carrollton, GA 30117-3738

Phone

(470) 215-0862

NPI assigned

Feb 18, 2019

Last updated

Feb 18, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Nicholas J Long, PT, DPT, CMTPT

Title

Owner/Physical Therapist

Phone

(920) 940-8350

Specialties & licenses 1

Addresses

Other identifiers 2

Other names 1

• Somatic Physical Therapy Former legal business name

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

{
    "created_epoch": "1550448000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1550448000000",
    "number": "1528524352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1576 FOLKSTONE RD NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303291305",
            "telephone_number": "920-940-8350",
            "fax_number": "404-393-4680"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 SOUTH ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173738",
            "telephone_number": "470-215-0862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1576 Folkstone Rd NE",
            "address_purpose": "LOCATION",
            "city": "Brookhaven",
            "state": "GA",
            "postal_code": "303291305",
            "country_code": "US",
            "telephone_number": "920-940-8350",
            "fax_number": "404-393-4680",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOMATIC PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-02-18",
        "last_updated": "2019-02-18",
        "status": "A",
        "authorized_official_last_name": "LONG",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "920-940-8350",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT, CMTPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE NUMBER",
            "identifier": "PT009781",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DRY NEEDLING CERTIFICATION, MYOPAIN 6-10-18",
            "identifier": "18158",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Somatic Physical Therapy",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

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• Physical Therapy Clinic/Center in Carrollton, GA
• Providers in Carrollton, GA by specialty
• Physical Therapy Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2019; 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.