Individual provider Active NPI

Kirtika Patel

  • Physical Therapist
  • Acworth, GA
National Provider Identifier
1578722682
Registry record updated Jul 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT009929 Issued in GA
Practice address
3450 Cobb Pkwy NW Ste 220
Acworth, GA 30101-8352
Phone
(770) 974-1978
NPI assigned
Jun 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT009929 GA Primary

Addresses

Primary practice location

3450 Cobb Pkwy NW Ste 220
Acworth, GA 30101-8352

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 541-3263

Other practice location 1

5495 Heatherbrooke Dr NW
Acworth, GA 30101-7182
Phone (706) 459-0102

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210827001647 GA Practitioner - Physical Therapist in Private Practice 8820164924 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independent Physical Therapy of Georgia, LLCGroup PAC ID 2961312244, 526 clinicians

Practice addresses (Care Compare)

1025 E W Connector
Suite 406
Austell, GA 30106-8531
Phone (770) 384-1001

3450 Cobb Pkwy NW
Suite 210
Acworth, GA 30101-8352
Phone (770) 974-1978

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT009929GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy of Georgia, LLC Physical Therapist Current Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jun 28, 2021 Accepting new patients
Independent Physical Therapy, LLC CurrentSince Jun 28, 2021 Accepting new patients
Orthopedic Associates of Naperville SC PastSince Oct 24, 2007 Accepting new patients

Locations

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

3450 Cobb Pkwy NW
Ste 210
Acworth, GA 30101
Phone (770) 974-1978

3450 Cobb Pkwy NW
Ste 220
Acworth, GA 30101
Phone (770) 974-1978

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

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": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1578722682",
    "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",
            "telephone_number": "423-541-3263"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 COBB PKWY NW STE 220",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301018352",
            "telephone_number": "770-974-1978"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5495 Heatherbrooke Dr NW",
            "address_purpose": "LOCATION",
            "city": "Acworth",
            "state": "GA",
            "postal_code": "301017182",
            "country_code": "US",
            "telephone_number": "706-459-0102",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATEL",
        "first_name": "KIRTIKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT009929",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; 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.