Active NPI
Callie Deloach, PT, DPT
- Physical Therapist
- Cleveland, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT014630
- Practice address
- 105 N Main St Ste C
Cleveland, GA 30528-1123 - Phone
- (706) 219-4507
- Fax
- (706) 865-1501
- NPI assigned
- Jul 31, 2020
- Sex
- Female
- 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 | PT014630 | GA | Primary |
Addresses
Primary practice location
105 N Main St Ste C
Cleveland, GA 30528-1123
Mailing address
1200 Corporate Dr Ste 400
Birmingham, AL 35242-5424
Phone (423) 238-7217
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1025 E W Connector
Suite 406
Austell, GA 30106-8531
Phone (770) 384-1001
3630 Thompson Bridge Rd
Suite 4
Gainesville, GA 30506-1523
Phone (678) 971-4235
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT014630 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Independent Physical Therapy of Georgia, LLC | Physical Therapist | Current | Accepting new patients |
| Independent Physical Therapy of Georgia, LLC | Physical Therapist | Current | Accepting new patients |
Locations
1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568
1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001
105 N Main St
Ste C
Cleveland, GA 30528
Phone (706) 219-4507
3630 Thompson Bridge Rd
Ste 4
Gainesville, GA 30506
Phone (678) 971-4235
Organizations & group practices 2
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
- Fort Oglethorpe, GA
- NPI 1780636068
-
- Occupational Therapist
- Gainesville, GA
- NPI 1306013941
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1596153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1596153600000",
"number": "1659980084",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 CORPORATE DR STE 400",
"city": "BIRMINGHAM",
"state": "AL",
"postal_code": "352425424",
"telephone_number": "423-238-7217",
"fax_number": "423-238-3473"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "105 N MAIN ST STE C",
"city": "CLEVELAND",
"state": "GA",
"postal_code": "305281123",
"telephone_number": "706-219-4507",
"fax_number": "706-865-1501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DELOACH",
"first_name": "CALLIE",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-07-31",
"last_updated": "2020-07-31",
"certification_date": "2020-07-31",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT014630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Cleveland, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.