Elizabeth Grace Babcock, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT014671 Issued in GA

Practice address

2001 Church LN
Villa Rica, GA 30180-4720

Phone

(770) 459-6533

NPI assigned

Jun 26, 2020

Last updated

Aug 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1609493626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "212 RETREAT VLG",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315222403",
            "telephone_number": "912-638-1444",
            "fax_number": "912-638-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2001 CHURCH LN",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "301804720",
            "telephone_number": "770-459-6533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BABCOCK",
        "first_name": "ELIZABETH",
        "middle_name": "GRACE",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-26",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014671",
            "primary": true
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Pediatrics",
            "state": "GA",
            "license": "PT014671",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Villa Rica, GA
• Providers in Villa Rica, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.