Peach State Providers Group Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

1741 Issued in GA

Legal business name

PEACH STATE PROVIDERS GROUP INC

Practice address

7146 Southlake Parkway
Morrow, GA 30260

Phone

(770) 960-9979

Fax

(770) 960-9662

NPI assigned

Feb 15, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Brenda R Talley, RPT

Title

Physical Therapist

Phone

(770) 960-9979

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Susan Mary Markle, O.T.R.

  • Pediatric Occupational Therapist
  • Morrow, GA
  • NPI 1093848087
  NPD (past)

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

{
    "created_epoch": "1171497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1629111802",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 HAWN ROAD",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "30215",
            "telephone_number": "770-460-1494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7146 SOUTHLAKE PARKWAY",
            "city": "MORROW",
            "state": "GA",
            "postal_code": "30260",
            "telephone_number": "770-960-9979",
            "fax_number": "770-960-9662"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACH STATE PROVIDERS GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "TALLEY",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "770-960-9979",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "1741",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00881218A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Scott Juyoung Park, DMD
• Parsley Medical Group FL PA (Parsley Medical Group of GA)
• Jherricka Partido
• Peace It's Priceless (Peace)
• Peaceful Healthcare LLC
• Patrice N. Pearson, MD
• Sir Allen Pegues
• Dominique Peterson
• Allison Petty, OD
• Pex Medibridge Solution Corp

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.