Independent Physical Therapy of Georgia, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC

Practice address

8823 Production LN
Ooltewah, TN 37363-6511

Phone

(423) 238-7217

Fax

(423) 238-3473

NPI assigned

Jun 15, 2012

Organization subpart

No

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

Authorized official

Name

Kiley Russell

Title

Manager

Phone

(423) 238-8923

Specialties & licenses 2

Addresses

Other names 1

• BenchMark Physical Therapy Other name

Tax ID family

Independent Physical TH161 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 1

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Independent Physical Therapy of Georgia, LLC

  • Physical Therapist
  • Ooltewah, TN
  • NPI 1609034073
  NPD tax ID

Practitioners 1

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

• Troy Dale Bage, PT

  • Physical Therapist
  • Ooltewah, TN
  • NPI 1679650824
  NPD (past)

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

{
    "created_epoch": "1339718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1339977600000",
    "number": "1669734554",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4959 BILL GARDNER PKWY",
            "address_2": "STE 109",
            "city": "LOCUST GROVE",
            "state": "GA",
            "postal_code": "302482915",
            "telephone_number": "770-914-9285",
            "fax_number": "770-914-5668"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-15",
        "last_updated": "2012-06-18",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "KILEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "423-238-8923"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BenchMark Physical Therapy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Lorri Lynn Ilchuk, PT
• Patrick H Im, D.D.S.
• Independent Physical Therapy LLC
• Independent Physical Therapy LLC
• Independent Physical Therapy of Georgia, LLC
• Inspire Home Respiratory Services Inc. (Airstat Inc.)
• Inspire Kids Dental PLLC
• Juhyan Jang, PT
• Leah Suzanne Jarrell, FNP
• Jason Vance MD a Medical Corporation

• Physical Therapy Clinic/Center in Ooltewah, TN
• Providers in Ooltewah, TN by specialty
• Physical Therapy Clinic/Center in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 18, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.