Omar Ibreak

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

3575 Durden Dr NE
Brookhaven, GA 30319-2253

Phone

(404) 469-9005

NPI assigned

Nov 21, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Verispine Joint Centers PC

  • Interventional Pain Medicine Physician
  • Stockbridge, GA
  • NPI 1982313532
  NPD (past)

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

{
    "created_epoch": "1574294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574294400000",
    "number": "1639715931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2475 CLAIRVIEW ST",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300098319"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3575 DURDEN DR NE",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303192253",
            "telephone_number": "404-469-9005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IBREAK",
        "first_name": "OMAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-11-21",
        "last_updated": "2019-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Unknown",
            "affiliation": "N",
            "address_1": "3575 Durden Dr NE",
            "city": "Brookhaven",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303192253",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hunter Clinics, PC
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• Alan Hymowitz, O.D.
• Danielle Ibelema, M.D
• Jessica Tope Igbalajobi, PMHNP
• Independent Physical Therapy of Ga, LLC
• Inner Peace Counseling Services
• Inspyre You Health & Wellness
• Intown Speech Therapy, LLC

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2019; 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.