Individual provider Active NPI

William Small, DPT

  • Physical Therapist
  • Marietta, GA
National Provider Identifier
1629744222
Registry record updated Aug 23, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT015550 Issued in GA
Practice address
3460 Sandy Plains Rd Unit 610
Marietta, GA 30066-4766
Phone
(678) 631-5878
Fax
(678) 681-9112
NPI assigned
Aug 23, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 23, 2021

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 PT015550 GA Primary

Addresses

Primary practice location

3460 Sandy Plains Rd Unit 610
Marietta, GA 30066-4766

Mailing address

PO Box 306393
Nashville, TN 37230-6393
Phone (615) 373-1350

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210830001008 GA Practitioner - Physical Therapist in Private Practice 9133524192 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jun 6, 2024 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Sep 1, 2021 Accepting new patients
Benchmark Physical Therapy, Inc CurrentSince Jun 6, 2024 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jun 6, 2024 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Sep 1, 2021 Accepting new patients
Benchmark Physical Therapy Inc Physical Therapist CurrentSince Jun 6, 2024 Accepting new patients

Locations

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

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

2500 Dallas Hwy SW
Ste 520
Marietta, GA 30064
Phone (678) 383-1696

3460 Sandy Plains Rd
Unit 610
Marietta, GA 30066
Phone (678) 631-5878

6635 Roswell Rd
Sandy Springs, GA 30328
Phone (678) 332-2030

Organizations & group practices 6

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": "1629676800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1629676800000",
    "number": "1629744222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 306393",
            "city": "NASHVILLE",
            "state": "TN",
            "postal_code": "372306393",
            "telephone_number": "615-373-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3460 SANDY PLAINS RD UNIT 610",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300664766",
            "telephone_number": "678-631-5878",
            "fax_number": "678-681-9112"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMALL",
        "first_name": "WILLIAM",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-08-23",
        "last_updated": "2021-08-23",
        "certification_date": "2021-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT015550",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2021; 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.

Verify at the official NPI Registry.