Fixtpt Lawrenceville LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

FIXTPT LAWRENCEVILLE LLC

Practice address

455 Philip Blvd Ste 135
Lawrenceville, GA 30046-8767

Phone

(404) 799-7050

NPI assigned

Nov 9, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Pavel Gorokhov, PTNPI 1881110914

Title

Clinic Director/PT

Phone

(404) 779-7050

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Pavel Alexander Gorokhov, PT, DPT

  • Physical Therapist
  • Lawrenceville, GA
  • NPI 1881110914
  Medicare reassignment Care Compare group NPD Authorized official
• Danielle Nicole Bennett, PT, DPT

  • Physical Therapist
  • Roswell, GA
  • NPI 1659897791
  Medicare reassignment Care Compare group NPD
• Elliot Ming-Yi Teh, PT, DPT

  • Physical Therapist
  • Lawrenceville, GA
  • NPI 1780100743
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1699488000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1702857600000",
    "number": "1548034507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 PHILIP BLVD STE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468767",
            "telephone_number": "404-799-7050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 PHILIP BLVD STE 135",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300468767",
            "telephone_number": "404-799-7050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FIXTPT LAWRENCEVILLE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-09",
        "last_updated": "2023-12-18",
        "certification_date": "2023-12-18",
        "status": "A",
        "authorized_official_last_name": "GOROKHOV",
        "authorized_official_first_name": "PAVEL",
        "authorized_official_title_or_position": "CLINIC DIRECTOR/PT",
        "authorized_official_telephone_number": "404-779-7050",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karyn Fishman
• Christopher Fisk, RN
• Craig Richard Fisk, DDS
• S Jan Fitzgerald-Soapes, M.D.
• Aaliyah Fitzgerald
• Lisa C Flachbarth, ANP-BC, GNP-BC
• Elizabeth Jones Flail, D.O.
• Flamede Health Care LLC (Flamede Home Care LLC)
• Ursula Delora Flanagan
• Akeala M Flanigan

• Physical Therapy Clinic/Center in Lawrenceville, GA
• Providers in Lawrenceville, 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 Dec 18, 2023; 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.