Individual provider Active NPI

Michael Wong, PT

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1679213607
Registry record updated Jan 13, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
CP038862T Issued in GA
Practice address
2900 Peachtree Rd NW Ste 208
Atlanta, GA 30305-2189
Phone
(678) 365-3588
NPI assigned
Mar 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 13, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 008558 KY
Orthopedic Physical Therapist 2251X0800X LPT-32127 AZ
Physical Therapist 225100000X CP038862T GA Primary

Addresses

Primary practice location

2900 Peachtree Rd NW Ste 208
Atlanta, GA 30305-2189

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 497-0005

Other practice location 1

103 S Pine St
Pineville, KY 40977-1610
Phone (606) 254-2075

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250408000261 GA Practitioner - Physical Therapist in Private Practice 3870980477 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
008558KYMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy, Inc Physical Therapist CurrentSince Jan 26, 2025 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Jan 13, 2025 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Jan 13, 2025 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jan 26, 2025 Accepting new patients
Independent Physical Therapy of Ga, LLC Physical Therapist CurrentSince Jan 26, 2025 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist Current Accepting new patients
Benchmark Physical Therapy, Inc CurrentSince Jan 26, 2025 Accepting new patients
Physiotherapy Associates Inc Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

2255 Peachtree Rd NE
Ste G
Atlanta, GA 30309
Phone (404) 351-3257

2900 Peachtree Rd NW
Ste 208
Atlanta, GA 30305
Phone (678) 365-3588

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

860 Johnson Fy Rd NE
Ste 100
Sandy Springs, GA 30342
Phone (404) 252-5545

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1648512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736726400000",
    "number": "1679213607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-497-0005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 PEACHTREE RD NW STE 208",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303052189",
            "telephone_number": "678-365-3588"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "103 S Pine St",
            "address_purpose": "LOCATION",
            "city": "Pineville",
            "state": "KY",
            "postal_code": "409771610",
            "country_code": "US",
            "telephone_number": "606-254-2075",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WONG",
        "first_name": "MICHAEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-29",
        "last_updated": "2025-01-13",
        "certification_date": "2025-01-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "KY",
            "license": "008558",
            "primary": false
        },
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "AZ",
            "license": "LPT-32127",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "CP038862T",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jan 13, 2025; 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.