NPIMap

Organization Active NPI

Peachtree Orthopaedic Clinic, P.a..

Doing business as Peachtree Orthopaedic Physical Therapy

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1609812593
Registry record updated Mar 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PEACHTREE ORTHOPAEDIC CLINIC, P.A..
Doing business as
Peachtree Orthopaedic Physical Therapy
Practice address
365 Peachtree Hills Ave NE
Suite 201
Atlanta, GA 30305-4531
Phone
(404) 355-8066
Fax
(404) 816-4460
NPI assigned
Jun 21, 2006
Last updated
Mar 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 17, 2008

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

Authorized official

Name
Greg Cooper
Title
Managing Partner
Phone
(219) 365-6560

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

365 Peachtree Hills Ave NE
Suite 201
Atlanta, GA 30305-4531

Mailing address

365 Peachtree Hills Ave NE
Suite 201
Atlanta, GA 30305-4531
Phone (404) 355-8066

Other names 1

  • Peachtree Orthopaedic Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040308000751 GA Part B Supplier - Clinic/Group Practice 4587552963 Receives reassigned benefits from 145 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alpharetta, GA; Woodstock, GA; Marietta, GA; Duluth, GA; Dawsonville, GA; Cumming, GA; College Park, GA; Atlanta, GA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205712000000",
    "number": "1609812593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "365 PEACHTREE HILLS AVE NE",
            "address_2": "SUITE 201",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303054531",
            "telephone_number": "404-355-8066",
            "fax_number": "404-816-4460"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "365 PEACHTREE HILLS AVE NE",
            "address_2": "SUITE 201",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303054531",
            "telephone_number": "404-355-8066",
            "fax_number": "404-816-4460"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE ORTHOPAEDIC CLINIC, P.A..",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2008-03-17",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "219-365-6560"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peachtree Orthopaedic Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.