Lake Country Physical Therapy LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT004255 Issued in GA

Legal business name

LAKE COUNTRY PHYSICAL THERAPY LLC

Practice address

121 Sebastian Dr
Eatonton, GA 31024-5750

Phone

(706) 473-2348

NPI assigned

Jul 15, 2013

Organization subpart

No

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

Authorized official

Name

Mr. Charles Richard Eisele, P.T.

Title

Physical Therapist

Phone

(706) 473-2348

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Jennifer Maureen Carawan, LPTA

  • Physical Therapy Assistant
  • Eatonton, GA
  • NPI 1104003151
  NPD

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1373846400000",
    "number": "1548601909",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 SEBASTIAN DR",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310245750",
            "telephone_number": "706-473-2348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 SEBASTIAN DR",
            "city": "EATONTON",
            "state": "GA",
            "postal_code": "310245750",
            "telephone_number": "706-473-2348"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LAKE COUNTRY PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-07-15",
        "last_updated": "2013-07-15",
        "status": "A",
        "authorized_official_last_name": "EISELE",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "706-473-2348",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT004255",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ajay Kumar, M.D.
• Rakesh Kumar, MD
• Lake Country Family Chiropractic LLC
• Lake Country Language and Literacy LLC
• Lake Country Pharmacy LLC
• Lake Oconee Medical Associates LLC
• Lake Oconee Partners in Healthcare, LLC
• Lake Oconee Pharmacy & Compounding Center
• Lake Oconee Rehabilitation and Performance Center, LLC
• Lake Oconee Urgent and Specialty Care Center

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 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.