Independent Physical Therapy of Georgia, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC

Practice address

4600 W Village PL SE Ste 4007
Smyrna, GA 30080-9213

Phone

(770) 438-2015

Fax

(770) 438-8536

NPI assigned

May 30, 2012

Organization subpart

No

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

Authorized official

Name

Kiley Russell

Title

Manager

Phone

(423) 238-8923

Specialties & licenses 3

Addresses

Other names 1

• BenchMark Other name

Tax ID family

Independent Physical Therapy LLC98 organizations share this tax ID, including this one

Practitioners 1

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

• Troy Dale Bage, PT

  • Physical Therapist
  • Ooltewah, TN
  • NPI 1679650824
  NPD (past)

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

{
    "created_epoch": "1338336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1338854400000",
    "number": "1558622217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4600 W VILLAGE PL SE STE 4007",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300809213",
            "telephone_number": "770-438-2015",
            "fax_number": "770-438-8536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-05-30",
        "last_updated": "2012-06-05",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "KILEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "423-238-8923"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BenchMark",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Nur Banu Ibaoglu Vaughn, MA, LPC
• Frances Offiah Idowu, NP-C
• Aya Ieki, ATC
• Blessing Ada Ikonne, NP- C
• In Time of Need, Inc.
• Indira Thomasson LLC
• Infinite Comfort Care (Senior Helpers)
• Infinity Leg Solutions
• Innovative Infusions, LLC (Paragon Infusion Centers)
• Innovative Women's Healthcare Solutions, LLC

• Physical Therapy Clinic/Center in Smyrna, GA
• Providers in Smyrna, 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 Jun 5, 2012; 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.