Active NPI
PT Solutions of Acworth, LLC
- Physical Therapist
- Cartersville, GA
National Provider Identifier
1619202355
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- PT SOLUTIONS OF ACWORTH, LLC
- Practice address
- 150 Gentilly Blvd
Cartersville, GA 30120-8522 - Phone
- (866) 464-3878
- NPI assigned
- Oct 14, 2009
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dale M Yake
- Title
- Coo
- Phone
- (770) 917-0924
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
150 Gentilly Blvd
Cartersville, GA 30120-8522
Mailing address
PO Box 242278
Montgomery, AL 36124-2278
Phone (334) 396-3273
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040629000794 | GA | Part B Supplier - Clinic/Group Practice | 0042291817 |
Receives reassigned benefits from 14 practitioners 33 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Hahira, GA; Watkinsville, GA; Villa Rica, GA; Valdosta, GA; Tyrone, GA; Norcross, GA; Evans, GA; Decatur, GA… |
Other NPIs on the same Medicare enrollment 33
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
National Provider Directory
National Provider DirectoryNPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255478400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1255478400000",
"number": "1619202355",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 242278",
"city": "MONTGOMERY",
"state": "AL",
"postal_code": "361242278",
"telephone_number": "334-396-3273",
"fax_number": "334-396-4905"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 GENTILLY BLVD",
"city": "CARTERSVILLE",
"state": "GA",
"postal_code": "301208522",
"telephone_number": "866-464-3878"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PT SOLUTIONS OF ACWORTH, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2009-10-14",
"last_updated": "2009-10-14",
"status": "A",
"authorized_official_last_name": "YAKE",
"authorized_official_first_name": "DALE",
"authorized_official_middle_name": "M",
"authorized_official_title_or_position": "COO",
"authorized_official_telephone_number": "770-917-0924"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cartersville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2009; 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.