Kevin M Avilla, PT, ATC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT010906 Issued in GA

Practice address

1180 Satellite Blvd NW
Suite 100
Suwanee, GA 30024-4636

Phone

(404) 367-2080

Fax

(770) 495-3493

NPI assigned

Apr 3, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Locations

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.

• Hingham Physical Therapy, Inc.

  • Specialist
  • Hingham, MA
  • NPI 1366414211

  Physical Therapist

  NPD
• High Performance Physical Therapy Centers

  • Physical Therapist
  • Suwanee, GA
  • NPI 1467645689
  NPD (past)

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385078400000",
    "number": "1538280698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1180 SATELLITE BLVD NW",
            "address_2": "SUITE 100",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244636",
            "telephone_number": "404-367-2080",
            "fax_number": "770-495-3493"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1180 SATELLITE BLVD NW",
            "address_2": "SUITE 100",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300244636",
            "telephone_number": "404-367-2080",
            "fax_number": "770-495-3493"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILLA",
        "first_name": "KEVIN",
        "middle_name": "M",
        "name_prefix": "Mr.",
        "credential": "PT, ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-03",
        "last_updated": "2013-11-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "MA",
            "license": "1356",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "20091",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT010906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Audiology Services Company USA, LLC
• Auguste Health Associates Aha Inc
• Aurora Surgical Specialists
• Austin Therapy Associates, LLC
• Avant Home Care LLC
• Shubh Ayengar, M.D.
• Laura Leigh Ayer, LPC
• Aylo Health, LLC
• Aymethist LLC
• Azal Hospice and Palliative LLC

• Physical Therapist in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2013; 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.