NPIMap

Organization Active NPI

Restorative Therapy & Wellness, LLC

  • Physical Therapist
  • Dunwoody, GA
National Provider Identifier
1649500778
Registry record updated Jan 12, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT008500 Issued in GA
Legal business name
RESTORATIVE THERAPY & WELLNESS, LLC
Practice address
2330 Welton PL
Dunwoody, GA 30338-5345
Phone
(610) 659-0329
Fax
(770) 986-6109
NPI assigned
Jan 12, 2010
Last updated
Jan 12, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 12, 2010

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

Authorized official

Name
Dr. Deborah Elaine Koval, PTNPI 1861548752
Title
Managing Member/Owner
Phone
(610) 659-0329

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT008500 GA Primary

Addresses

Primary practice location

2330 Welton PL
Dunwoody, GA 30338-5345

Mailing address

2330 Welton PL
Dunwoody, GA 30338-5345
Phone (610) 659-0329

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20100409000016 GA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0244366763 Receives reassigned benefits from 6 practitioners
Practice locations: Atlanta, GA

National Provider Directory

National Provider Directory

Locations

5881 Glenridge Dr
Ste 170
Sandy Springs, GA 30328
Phone (404) 236-0934

Practitioners & affiliated clinicians

Practitioners 10

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": "1263254400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1263254400000",
    "number": "1649500778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2330 WELTON PL",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303385345",
            "telephone_number": "610-659-0329",
            "fax_number": "770-986-6109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2330 WELTON PL",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303385345",
            "telephone_number": "610-659-0329",
            "fax_number": "770-986-6109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATIVE THERAPY & WELLNESS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-12",
        "last_updated": "2010-01-12",
        "status": "A",
        "authorized_official_last_name": "KOVAL",
        "authorized_official_first_name": "DEBORAH",
        "authorized_official_middle_name": "ELAINE",
        "authorized_official_title_or_position": "MANAGING MEMBER/OWNER",
        "authorized_official_telephone_number": "610-659-0329",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008500",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunwoody, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 12, 2010; 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.