Individual provider Active NPI

Darra Murti, PT

  • Physical Therapist
  • Suwanee, GA
National Provider Identifier
1619174794
Registry record updated Sep 18, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1171748 Issued in TX
Practice address
2780 W Village Dr Ste G
Suwanee, GA 30024-5536
Phone
(470) 533-4610
NPI assigned
Jul 2, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1171748 TX Primary

Addresses

Primary practice location

2780 W Village Dr Ste G
Suwanee, GA 30024-5536

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250305001976 GA Practitioner - Physical Therapist in Private Practice 6305990300 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1171748TXMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
MCM Rehabilitation, LLC. Physical Therapist CurrentSince Sep 9, 2024 Accepting new patients
MCM Rehabilitation LLC CurrentSince Sep 9, 2024 Accepting new patients

Locations

7775 McGinnis Ferry Rd
Ste 103
Johns Creek, GA 30024
Phone (678) 537-6881

97 Gateway Business Park Dr
Ringgold, GA 30736
Phone (706) 937-5771

2780 W Village Dr
Ste G
Suwanee, GA 30024
Phone (470) 533-4610

790 Remington Blvd
Bolingbrook, IL 60440

4947 Paysphere Cr
Chicago, IL 60674

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1183334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726617600000",
    "number": "1619174794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2780 W VILLAGE DR STE G",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300245536",
            "telephone_number": "470-533-4610"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MURTI",
        "first_name": "DARRA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-02",
        "last_updated": "2024-09-18",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "TX",
            "license": "1171748",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2024; 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.