NPIMap

Organization Active NPI

Gainesville Physical Therapy LLC

  • Physical Therapist
  • Gainesville, GA
National Provider Identifier
1649308156
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
GAINESVILLE PHYSICAL THERAPY LLC
Practice address
1296 Sims St
Suite a
Gainesville, GA 30501-3850
Phone
(770) 297-1700
Fax
(770) 297-1702
NPI assigned
Feb 28, 2007
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Gail Consola
Title
Ar Director
Phone
(770) 297-1700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

1296 Sims St
Suite a
Gainesville, GA 30501-3850

Mailing address

1296 Sims St
Suite a
Gainesville, GA 30501-3850
Phone (770) 297-1700

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20051026000665 GA Part B Supplier - Clinic/Group Practice 3971520271 Receives reassigned benefits from 11 practitioners
Practice locations: Gainesville, GA

National Provider Directory

National Provider Directory
Tax ID family
Gainesville Physical Therapy LLC2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1296 Sims St
Ste A
Gainesville, GA 30501
Phone (770) 297-1700

Ownership & related parties

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1172620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1649308156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1296 SIMS ST",
            "address_2": "SUITE A",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013850",
            "telephone_number": "770-297-1700",
            "fax_number": "770-297-1702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1296 SIMS ST",
            "address_2": "SUITE A",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013850",
            "telephone_number": "770-297-1700",
            "fax_number": "770-297-1702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GAINESVILLE PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-28",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "CONSOLA",
        "authorized_official_first_name": "GAIL",
        "authorized_official_title_or_position": "AR DIRECTOR",
        "authorized_official_telephone_number": "770-297-1700"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • 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.
  • 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.