NPIMap

Organization Active NPI

Georgialina Physical Therapy Associates LLC

Doing business as Athletico Physical Therapy

  • Physical Therapist
  • Augusta, GA
National Provider Identifier
1679286934
Registry record updated Jan 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
GEORGIALINA PHYSICAL THERAPY ASSOCIATES LLC
Doing business as
Athletico Physical Therapy
Practice address
1321 Interstate Pkwy
Augusta, GA 30909-5626
Phone
(706) 945-0810
Fax
(706) 945-0821
NPI assigned
Jan 3, 2023
Last updated
Jan 3, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 3, 2023

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

Authorized official

Name
Juana Granados
Title
Credentialing Manager
Phone
(630) 575-1980

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

1321 Interstate Pkwy
Augusta, GA 30909-5626

Mailing address

2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (630) 575-1980

Other names 1

  • Athletico Physical Therapy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20070509000651 GA Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 6002812401 1 other NPI on this enrollment
Practice locations: Gainesville, GA; Augusta, GA; Warner Robins, GA; Thomson, GA; Martinez, GA; Kathleen, GA; Hephzibah, GA; Harlem, GA…
O20251230003055 GA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 6002812401 Receives reassigned benefits from 35 practitioners
Practice locations: Harlem, GA; Thomson, GA; Martinez, GA; Kathleen, GA; Hephzibah, GA; Grovetown, GA; Columbus, GA; Byron, GA…

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

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

National Provider Directory

National Provider Directory

Locations

1321 Interstate Pkwy
Augusta, GA 30909
Phone (706) 738-7246

1229 Friendship Rd
#200
Braselton, GA 30517
Phone (770) 415-9792

2501 Whittlesey Blvd
Unit 3
Columbus, GA 31909
Phone (762) 261-1900

205 Addison Sq
Ste 2
Evans, GA 30809
Phone (706) 309-0016

4039 Gateway Blvd
Ste 102
Grovetown, GA 30813
Phone (706) 210-9534

2556 Tobacco Rd
Ste C
Hephzibah, GA 30815
Phone (706) 309-0036

1117 GA Highway 96
Ste 112
Kathleen, GA 31047
Phone (478) 352-0200

2498 Washington Rd
#A
Thomson, GA 30824
Phone (706) 391-6232

Practitioners & affiliated clinicians

Practitioners 405

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 405

NPI Registry JSON

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

{
    "created_epoch": "1672704000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672704000000",
    "number": "1679286934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2122 YORK RD STE 300",
            "city": "OAK BROOK",
            "state": "IL",
            "postal_code": "605231925",
            "telephone_number": "630-575-1980",
            "fax_number": "630-928-5080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1321 INTERSTATE PKWY",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309095626",
            "telephone_number": "706-945-0810",
            "fax_number": "706-945-0821"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIALINA PHYSICAL THERAPY ASSOCIATES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-01-03",
        "last_updated": "2023-01-03",
        "certification_date": "2023-01-03",
        "status": "A",
        "authorized_official_last_name": "GRANADOS",
        "authorized_official_first_name": "JUANA",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "630-575-1980"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Athletico Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Augusta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2023; 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.