Independent Physical Therapy of Georgia, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC

Practice address

8823 Production LN
Ooltewah, TN 37363-6511

Phone

(423) 238-7217

Fax

(423) 238-3473

NPI assigned

Jun 2, 2008

Organization subpart

No

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

Authorized official

Name

Kevin Johanneson

Title

VP Revenue Cycle

Phone

(423) 238-7217

Specialties & licenses 3

Addresses

Other identifiers 1

Other names 1

• BenchMark Physical Therapy Other name

Tax ID family

Independent Physical TH161 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 1

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Independent Physical Therapy of Georgia, LLC

  • Physical Therapy Clinic/Center
  • Ooltewah, TN
  • NPI 1669734554
  NPD tax ID

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1506384000000",
    "number": "1609034073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212564",
            "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": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-02",
        "last_updated": "2017-09-26",
        "status": "A",
        "authorized_official_last_name": "JOHANNESON",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "VP REVENUE CYCLE",
        "authorized_official_telephone_number": "423-238-7217"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD (PART B CLINICS)",
            "identifier": "CK9205",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BenchMark Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Stephanie Huskins
• Lorri Lynn Ilchuk, PT
• Patrick H Im, D.D.S.
• Independent Physical Therapy LLC
• Independent Physical Therapy LLC
• Independent Physical Therapy of Georgia, LLC
• Inspire Home Respiratory Services Inc.
• Inspire Kids Dental PLLC
• Juhyan Jang, PT
• Leah Suzanne Jarrell, FNP

• Physical Therapist in Ooltewah, TN
• Providers in Ooltewah, TN by specialty
• Physical Therapist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2017; 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.