NPIMap

Organization Active NPI

Peachtree Orthopaedic Clinic, P.a.

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1659664399
Registry record updated May 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PEACHTREE ORTHOPAEDIC CLINIC, P.A.
Practice address
2045 Peachtree Rd NE Ste 600
Atlanta, GA 30309-1414
Phone
(404) 355-8066
NPI assigned
May 26, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 26, 2011

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

Authorized official

Name
Greg Cooper
Title
Managing Partner
Phone
(219) 365-6560

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

2045 Peachtree Rd NE Ste 600
Atlanta, GA 30309-1414

Mailing address

PO Box 105258
Atlanta, GA 30348-5258
Phone (404) 355-0743

Other names 1

  • Peachtree Orthopaedic Physical Therapy Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040308000751 GA Part B Supplier - Clinic/Group Practice 4587552963 Receives reassigned benefits from 145 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Alpharetta, GA; Woodstock, GA; Marietta, GA; Duluth, GA; Dawsonville, GA; Cumming, GA; College Park, GA; Atlanta, GA

Other NPIs on the same Medicare enrollment 5

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1306368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1306368000000",
    "number": "1659664399",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 105258",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303485258",
            "telephone_number": "404-355-0743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2045 PEACHTREE RD NE STE 600",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091414",
            "telephone_number": "404-355-8066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE ORTHOPAEDIC CLINIC, P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-26",
        "last_updated": "2011-05-26",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "219-365-6560"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Peachtree Orthopaedic Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2011; 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.