Pro Health & Fitness

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT003457 Issued in GA

Legal business name

PRO HEALTH & FITNESS

Practice address

1065 Boston RDG
Woodstock, GA 30189-3562

Phone

(770) 365-9309

NPI assigned

Jan 15, 2015

Last updated

Jan 15, 2015By 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

Mr. Gregg P Baumgartner, MAPT

Title

Responsible Party

Phone

(770) 365-9309

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1421280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1421280000000",
    "number": "1639568595",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1065 BOSTON RDG",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301893562",
            "telephone_number": "770-365-9309"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1065 BOSTON RDG",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301893562",
            "telephone_number": "770-365-9309"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO HEALTH & FITNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-01-15",
        "last_updated": "2015-01-15",
        "status": "A",
        "authorized_official_last_name": "BAUMGARTNER",
        "authorized_official_first_name": "GREGG",
        "authorized_official_middle_name": "P",
        "authorized_official_title_or_position": "RESPONSIBLE PARTY",
        "authorized_official_telephone_number": "770-365-9309",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MAPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT003457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2015; 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.