Marla Thurman Vandyck, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT001132 Issued in GA

Practice address

1088C Baxter St
Athens, GA 30606-6316

Phone

(706) 549-7400

Fax

(706) 549-7399

NPI assigned

Oct 1, 2008

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1222819200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1629229315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "195 MILES ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306011820",
            "telephone_number": "706-546-1333",
            "fax_number": "706-546-5807"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1088C BAXTER ST",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306066316",
            "telephone_number": "706-549-7400",
            "fax_number": "706-549-7399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "12605 Augusta Rd",
            "address_purpose": "LOCATION",
            "city": "Lavonia",
            "state": "GA",
            "postal_code": "305531053",
            "country_code": "US",
            "telephone_number": "706-356-1333",
            "fax_number": "706-356-1433",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "195 Miles St",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306011820",
            "country_code": "US",
            "telephone_number": "706-546-1333",
            "fax_number": "706-546-5807",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VANDYCK",
        "first_name": "MARLA",
        "middle_name": "THURMAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-10-01",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT001132",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST LICENSE",
            "identifier": "PT001132",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Philip Van Dyck, MD
• Robert Van Gallera, MD
• Kilian Van Rijn, MD
• Matthew Tyler Vance, LPC
• Victoria Elaine Vandeusen
• Peter Frandsen Vandyck, MD
• Radha S Vanmali, PHARM D
• Dawn Vanover, NP
• Audrey Maaike Vanpelt, DC
• Samuel Robert Varnadoe, COTA

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.