Individual provider Active NPI

Elizabeth McVicker, DPT

  • Physical Therapist
  • Macon, GA
National Provider Identifier
1538512132
Registry record updated Jun 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT014536 Issued in GA
Practice address
5429 Bowman Rd Ste 140
Macon, GA 31210-8903
Phone
(478) 219-9673
NPI assigned
Jul 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 29, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2305210282 VA
Physical Therapist 225100000X 13523-24 WI
Physical Therapist 225100000X PT.8226 PT SC
Physical Therapist 225100000X PT014536 GA Primary

Addresses

Primary practice location

5429 Bowman Rd Ste 140
Macon, GA 31210-8903

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424

Other practice location 1

1755 Wittington Place Ste. #175
Dallas, TX 75234
Phone (866) 221-5405

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230803000741 GA Practitioner - Physical Therapist in Private Practice 1052772373 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

4319 Hartley Bridge Rd
Suite 150
Macon, GA 31216-5866
Phone (478) 333-5111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT014536GAMDPhysical Therapist
PT.8226 PTSCMDPhysical Therapist
2305210282VAMDPhysical Therapist
13523-24WIMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jul 18, 2023 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jul 18, 2023 Accepting new patients
Benchmark Physical Therapy, Inc CurrentSince Jul 18, 2023 Accepting new patients
Benchmark Physical Therapy Inc Physical Therapist CurrentSince Jul 18, 2023 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

4319 Hartley Bridge Rd
Ste 150
Macon, GA 31216
Phone (478) 333-5111

1111 Lower Fayetteville Rd
Ste 2000
Newnan, GA 30265
Phone (770) 251-7284

Organizations & group practices 4

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": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687996800000",
    "number": "1538512132",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5429 BOWMAN RD STE 140",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312108903",
            "telephone_number": "478-219-9673"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1755 Wittington Place Ste. #175",
            "address_purpose": "LOCATION",
            "city": "Dallas",
            "state": "TX",
            "postal_code": "75234",
            "country_code": "US",
            "telephone_number": "866-221-5405",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCVICKER",
        "first_name": "ELIZABETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2023-06-29",
        "certification_date": "2023-06-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305210282",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WI",
            "license": "13523-24",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "PT.8226 PT",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 29, 2023; 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.