NPIMap

Organization Active NPI

PT Solutions of Acworth, LLC

  • Physical Therapist
  • Watkinsville, GA
National Provider Identifier
1679025167
Registry record updated Oct 31, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PT SOLUTIONS OF ACWORTH, LLC
Practice address
2061 Experiment Station Rd
Suite 403
Watkinsville, GA 30677-5328
Phone
(844) 734-2204
NPI assigned
Oct 31, 2016
Organization subpart
Yes
Parent organization
PT SOLUTIONS OF ACWORTH, LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Oct 31, 2016

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

Authorized official

Name
Jennifer Hall
Title
Chief Financial Officer
Phone
(770) 615-4856

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2061 Experiment Station Rd
Suite 403
Watkinsville, GA 30677-5328

Mailing address

PO Box 441146
Kennesaw, GA 30160-9522
Phone (770) 917-1935

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040629000794 GA Part B Supplier - Clinic/Group Practice 0042291817 Receives reassigned benefits from 14 practitioners
33 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hahira, GA; Watkinsville, GA; Villa Rica, GA; Valdosta, GA; Tyrone, GA; Norcross, GA; Evans, GA; Decatur, GA…

Other NPIs on the same Medicare enrollment 33

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

View all 33

National Provider Directory

National Provider Directory
Tax ID family
PT Solutions of Acworth LLC15 organizations share this tax ID, including this one
Part of
PT Solutions of Acworth LLC

Other organizations with this tax ID 14

Organizations that report the same tax identification number in the National Provider Directory.

View all 14

Locations

2061 Experiment Station Rd
Ste 403
Watkinsville, GA 30677
Phone (844) 734-2204

NPI Registry JSON

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

{
    "created_epoch": "1477872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477872000000",
    "number": "1679025167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 441146",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301609522",
            "telephone_number": "770-917-1935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2061 EXPERIMENT STATION RD",
            "address_2": "SUITE 403",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306775328",
            "telephone_number": "844-734-2204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PT SOLUTIONS OF ACWORTH, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PT SOLUTIONS OF ACWORTH, LLC",
        "enumeration_date": "2016-10-31",
        "last_updated": "2016-10-31",
        "status": "A",
        "authorized_official_last_name": "HALL",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CHIEF FINANCIAL OFFICER",
        "authorized_official_telephone_number": "770-615-4856"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Watkinsville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2016; 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.