Active NPI
Anthony Suarez
- Physical Therapist
- Kennesaw, GA
National Provider Identifier
1659828952
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT012628
- Practice address
- 1990 Vaughn Rd NW
Suite 330
Kennesaw, GA 30144-7098 - Phone
- (678) 403-3632
- NPI assigned
- Sep 2, 2016
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT012628 | GA | Primary |
Addresses
Primary practice location
1990 Vaughn Rd NW
Suite 330
Kennesaw, GA 30144-7098
Mailing address
1990 Vaughn Rd NW
Suite 330
Kennesaw, GA 30144-7098
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT012628 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| PT Solutions of Acworth LLC | Physical Therapist | Past | Accepting new patients |
Interoperability endpoints
- neutrauma.anthonysuarez@158541.advancedmd-direct.com
Organizations & group practices 1
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.
-
- Physical Therapist
- Kennesaw, GA
- NPI 1184075210
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1472774400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1472774400000",
"number": "1659828952",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1990 VAUGHN RD NW",
"address_2": "SUITE 330",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301447098"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1990 VAUGHN RD NW",
"address_2": "SUITE 330",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301447098",
"telephone_number": "678-403-3632"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUAREZ",
"first_name": "ANTHONY",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-09-02",
"last_updated": "2016-09-02",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT012628",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennesaw, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.