Individual provider Active NPI

Madison McCollough

  • Physical Therapist
  • Hiram, GA
National Provider Identifier
1598348245
Registry record updated Apr 30, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3827 Jimmy Lee Smith Pkwy Ste 122
Hiram, GA 30141-2804
Phone
(770) 943-1142
NPI assigned
Apr 30, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 30, 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 Primary

Addresses

Primary practice location

3827 Jimmy Lee Smith Pkwy Ste 122
Hiram, GA 30141-2804

Mailing address

311 Pinhurst Drive
Vinings, GA 30339

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
PT Solutions of Acworth LLC Physical Therapist PastSince May 16, 2021 Accepting new patients
Kennestone Hospital, Inc PastSince May 16, 2021 Accepting new patients

Organizations & group practices 2

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": "1619740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619740800000",
    "number": "1598348245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "311 PINHURST DRIVE",
            "city": "VININGS",
            "state": "GA",
            "postal_code": "30339"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3827 JIMMY LEE SMITH PKWY STE 122",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412804",
            "telephone_number": "770-943-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCOLLOUGH",
        "first_name": "MADISON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-30",
        "last_updated": "2021-04-30",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hiram, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2021; 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.