Individual provider Active NPI

Carly Lanier, PT, DPT

  • Physical Therapist
  • Buford, GA
National Provider Identifier
1619642600
Registry record updated Jan 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT015442 Issued in GA
Practice address
3919 Carter Rd # a
Buford, GA 30518-1628
Phone
(470) 589-1058
NPI assigned
Aug 11, 2021
Last updated
Jan 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 24, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT015442 GA Primary
Physical Therapist 225100000X 65298 OR

Addresses

Primary practice location

3919 Carter Rd # a
Buford, GA 30518-1628

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 497-0005

Other practice location 1

3100 Olympus Blvd Ste 500
Coppell, TX 75019-5473
Phone (866) 221-5405 ext. 4445

Other practice location 2

10517 Braddock Rd Ste D
Fairfax, VA 22032-2275
Phone (571) 351-5618

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC, VA, OR3 enrollments

Enrollment records 3

Enrollment IDStateProvider typePAC IDDetails
I20210826001875 DC Practitioner - Physical Therapist in Private Practice 6608271812 Reassigns benefits to 1 organization
I20210830000250 VA Practitioner - Physical Therapist in Private Practice 6608271812 Reassigns benefits to 1 organization
I20240808002301 OR Practitioner - Physical Therapist in Private Practice 6608271812 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lebanon Physical Therapy LLCGroup PAC ID 3375982036, 4 clinicians

Practice addresses (Care Compare)

1195 S Main St
Lebanon, OR 97355-3217
Phone (650) 235-0545

170 W Ellendale Ave
Suite 101
Dallas, OR 97338-1456
Phone (503) 420-4287

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT015442GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy of Or, LLC Physical Therapist CurrentSince Jul 22, 2024 Accepting new patients
Lebanon Physical Therapy, LLC Physical Therapist CurrentSince Sep 15, 2025 Accepting new patients
Jackson Clinics Limited Partnership Physical Therapist CurrentSince Aug 23, 2021 Accepting new patients
Benchmark Physical Therapy of Oregon LLC Physical Therapist CurrentSince Jul 22, 2024 Accepting new patients
The Jackson Clinics LLC Physical Therapist PastSince Aug 23, 2021 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

170 W Ellendale Ave
Ste 101
Dallas, OR 97338
Phone (503) 420-4287

1195 S Main St
Lebanon, OR 97355
Phone (541) 401-6500

3007 NE West Devils Lake Rd
Lincoln City, OR 97367
Phone (541) 994-6252

3512 Excel Dr
Ste 105
Medford, OR 97504
Phone (541) 245-0419

43490 Yukon Dr
Ashburn, VA 20147
Phone (703) 729-7920

10517 Braddock Rd
Ste D
Fairfax, VA 22032
Phone (571) 351-5618

12701 Fair Lakes Cir
Ste 102
Fairfax, VA 22033

8140 Ashton Ave
Ste 104
Manassas, VA 20109
Phone (703) 257-3333

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1628640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737676800000",
    "number": "1619642600",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-497-0005",
            "fax_number": "571-370-3687"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3919 CARTER RD # A",
            "city": "BUFORD",
            "state": "GA",
            "postal_code": "305181628",
            "telephone_number": "470-589-1058"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3100 Olympus Blvd Ste 500",
            "address_purpose": "LOCATION",
            "city": "Coppell",
            "state": "TX",
            "postal_code": "750195473",
            "country_code": "US",
            "telephone_number": "866-221-5405 x4445",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "10517 Braddock Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Fairfax",
            "state": "VA",
            "postal_code": "220322275",
            "country_code": "US",
            "telephone_number": "571-351-5618",
            "fax_number": "571-351-5618",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANIER",
        "first_name": "CARLY",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-11",
        "last_updated": "2025-01-24",
        "certification_date": "2025-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT015442",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "65298",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Buford, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2025; 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.