Christopher Allen Goult, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT011818 Issued in GA

Practice address

2295 Towne Lake Pkwy
Ste 148
Woodstock, GA 30189-5520

Phone

(770) 926-2744

Fax

(770) 926-2794

NPI assigned

Jun 12, 2012

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA, FL2 enrollments

Enrollment records 2

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

One Place Rehab, LLCGroup PAC ID 6204312176, 4 clinicians

One Place Performance and Osteopractic Physical TherapyGroup PAC ID 1658803796, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• One Place Performance and Osteopractic Physical Therapy

  • Orthopedic Physical Therapist
  • University Park, FL
  • NPI 1366272486
  Medicare reassignment Care Compare group NPD
• One Place Rehab, LLC

  • Physical Therapist
  • Bradenton, FL
  • NPI 1013886613
  Medicare reassignment Care Compare group NPD
• Independent Physical Therapy of Georgia, LLC

  • Physical Therapist
  • Fort Oglethorpe, GA
  • NPI 1780636068
  Medicare reassignment NPD
• Independent Physical Therapy of Georgia, LLC

  • Occupational Therapist
  • Gainesville, GA
  • NPI 1306013941

  Physical Therapist

  NPD

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

{
    "created_epoch": "1339459200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1487894400000",
    "number": "1578825915",
    "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": "423-362-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 TOWNE LAKE PKWY",
            "address_2": "STE 148",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301895520",
            "telephone_number": "770-926-2744",
            "fax_number": "770-926-2794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GOULT",
        "first_name": "CHRISTOPHER",
        "middle_name": "ALLEN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-12",
        "last_updated": "2017-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IN",
            "license": "05010868A",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011818",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201110310",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Raegan Lentz Gordon, BCBA
• Evan Steve Gore, CAC II
• Patricia E. Gore, PSY.D.
• Dana Gorum
• Sidney A Gottlieb, O.D.
• Graham Pediatrics of Woodstock LLC
• Fitzroy Henry Graham, MD
• Rachel Graham, NTP
• Rebecca Crawford Graham, MA, LPC, CACII
• Grainne Transportation LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2017; 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.