John T Bassett V, PT
Individual provider Active NPI Physical Therapist · Villa Rica, GA
NPI 1609104017 · NPPES record last updated Nov 23, 2009
Key facts
- NPI
- 1609104017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT009823 (GA)
- Practice address
- 2000 Mirror Lake Blvd
Suite S
Villa Rica, GA 30180-2124 - Phone
- (770) 456-7877
- Fax
- (706) 456-7880
- NPI assigned
- Nov 23, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Accel Physical Therapy Inc
Practice addresses (Care Compare)
2000 Mirror Lake Blvd
Suite S
Villa Rica, GA 30180-2126
Phone (404) 667-5001
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20100111000499 | GA | Practitioner - Physical Therapist in Private Practice | 5991846115 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Accel Physical Therapy Inc | Physical Therapist | Current |
Accepting new patients |
Locations
120 Cunningham Dr
Ste F
Carrollton, GA 30117
Phone (678) 664-1467
500 Nathan Dean Blvd
Ste 108
Dallas, GA 30157
Phone (678) 402-7770
2983 Chapel Hill Rd
Ste 106
Douglasville, GA 30135
Phone (770) 947-8177
2000 Mirror Lake Blvd
Ste S
Villa Rica, GA 30180
Phone (404) 667-5001
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT009823 | GA | Yes |
Addresses
Primary practice location
2000 Mirror Lake Blvd
Suite S
Villa Rica, GA 30180-2124
Mailing address
2000 Mirror Lake Blvd
Suite S
Villa Rica, GA 30180-2124
Phone (770) 456-7877
Other providers in Villa Rica, GA
- George W Bailey
- Jennifer Bailey
- Erika Ballard
- Bankhead Chiropractic
- Golden Barnett III
- Brittany A Bates
- Mary Rachel Baxter
- Michael A Beckerman
- Tavia Rena Bell
- Germain Dapaah Bempah
All providers in Villa Rica, GA · Physical Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 23, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.