Walter Lee Bishop, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT007644 Issued in GA

Practice address

2003 Alice St
Waycross, GA 31501-6209

Phone

(912) 285-0053

Fax

(912) 283-9289

NPI assigned

Jun 1, 2006

Last updated

Apr 6, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Sports Medicine and Rehab Therapy, LLCGroup PAC ID 1658415054, 6 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sports Medicine and Rehab Therapy, LLC

  dba SMaRT Physical Therapy

  • Physical Medicine & Rehabilitation Physician
  • Waycross, GA
  • NPI 1396079224
  Medicare reassignment Care Compare group NPD
• Sports Medicine and Rehab Therapy Camden

  dba SMART Physical Therapy

  • Physical Therapist
  • Kingsland, GA
  • NPI 1821796145
  NPD
• Advance Rehabilitation and Consulting

  • Physical Therapist
  • Rome, GA
  • NPI 1174518682
  NPD (past)
• Physical Therapy Plus, Inc

  dba PT Plus Too

  • Occupational Therapist
  • St Simons Island, GA
  • NPI 1124194261

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1149120000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491436800000",
    "number": "1609813229",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2003 ALICE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016209",
            "telephone_number": "912-285-0053",
            "fax_number": "912-283-9289"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2003 ALICE ST",
            "city": "WAYCROSS",
            "state": "GA",
            "postal_code": "315016209",
            "telephone_number": "912-285-0053",
            "fax_number": "912-283-9289"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BISHOP",
        "first_name": "WALTER",
        "middle_name": "LEE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-01",
        "last_updated": "2017-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT007644",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "390574913N",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00829509",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Donald Alan Bethea, D.D.S.
• Bethesda Recovery
• Bio-Medical Applications of Georgia, Inc. (Fresenius Kidney Care Waycross)
• Biocare Mobile, LLC
• Margaret Bishop
• Kelly Costello Blackmon, APRN
• Blackshear Family Practice
• Blackwell Dynamics LLC
• James Madison Blackwell, PT, DPT
• Scotty Blanchard Jr., DMD

• Physical Therapist in Waycross, GA
• Providers in Waycross, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.