Individual provider Active NPI

Albert James Mayhan IV, PT

  • Physical Therapist
  • Montgomery, AL
National Provider Identifier
1619421435
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH8098 Issued in AL
Practice address
1636 Mulberry St
Montgomery, AL 36106-1522
Phone
(334) 265-3199
NPI assigned
Aug 10, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 3, 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 PTH8098 AL Primary

Addresses

Primary practice location

1636 Mulberry St
Montgomery, AL 36106-1522

Mailing address

1636 Mulberry St
Montgomery, AL 36106-1522
Phone (334) 265-3199

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161216002199 AL Practitioner - Physical Therapist in Private Practice 6709166358 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Elite Rehab Holtville LLCGroup PAC ID 5698145035, 5 clinicians
Harmony Rehab Solutions IncGroup PAC ID 5890027023, 4 clinicians
Elite Rehab IncGroup PAC ID 9436476066, 12 clinicians

Practice addresses (Care Compare)

213 Lightwood Rd
Suite 2
Deatsville, AL 36022-3800
Phone (334) 543-4269

6942 Winton Blount Blvd
Montgomery, AL 36117-3556
Phone (334) 277-1234

935 Hwy 431
Suite 1
Roanoke, AL 36274-7332
Phone (334) 863-2068

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Elite Rehab Inc Physical Therapist Current Accepting new patients
Harmony Rehab Solutions Inc Physical Therapist CurrentSince May 23, 2024 Accepting new patients
Tallassee Rehab Physical Therapist CurrentSince Jun 26, 2023 Accepting new patients
Elite Rehab Inc Physical Therapist CurrentSince Sep 15, 2023 Accepting new patients
Elite Rehab Holtville LLC Physical Therapist CurrentSince Jun 26, 2023 Accepting new patients
Tallassee Rehab PC Physical Therapist CurrentSince Jun 26, 2023 Accepting new patients
PT Solutions of Acworth LLC Physical Therapist Past Accepting new patients

Locations

213 Lightwood Rd
Ste 2
Deatsville, AL 36022
Phone (334) 543-4269

6942 Winton Blount Blvd
Montgomery, AL 36117
Phone (334) 277-1234

1636 Mulberry St
Montgomery, AL 36106
Phone (334) 265-3199

935 Highway 431
Ste 1
Roanoke, AL 36274
Phone (334) 799-5853

1000 Friendship Rd
Tallassee, AL 36078
Phone (334) 283-8032

301 Wright St
Tuskegee, AL 36083
Phone (334) 241-5224

Organizations & group practices 7

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": "1470787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1619421435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1636 MULBERRY ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061522",
            "telephone_number": "334-265-3199"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1636 MULBERRY ST",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361061522",
            "telephone_number": "334-265-3199"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYHAN",
        "first_name": "ALBERT",
        "middle_name": "JAMES",
        "name_suffix": "IV",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-10",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH8098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.