Peachtree Women'S Physical Therapy, Inc

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

1439 Issued in GA

Legal business name

PEACHTREE WOMEN'S PHYSICAL THERAPY, INC

Practice address

110 Bastille Way
Suite 100a
Fayetteville, GA 30214-7620

Phone

(770) 461-5270

NPI assigned

Nov 21, 2008

Organization subpart

No

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

Authorized official

Name

Roberta Burney

Title

President

Phone

(770) 461-5270

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1227225600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1227225600000",
    "number": "1679728463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 ENGLEWOOD DR",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302143348",
            "telephone_number": "770-461-5270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 BASTILLE WAY",
            "address_2": "SUITE 100A",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147620",
            "telephone_number": "770-461-5270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHTREE WOMEN'S PHYSICAL THERAPY, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-21",
        "last_updated": "2008-11-21",
        "status": "A",
        "authorized_official_last_name": "BURNEY",
        "authorized_official_first_name": "ROBERTA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-461-5270"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "GA",
            "license": "1439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Peachtree Fayette Women'S Specialists
• Gretchen H Peacock, DMFT
• Shereese Nicole Pearsall
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• Pediatric Emergency Medicine Associates LLC
• Matthew Pedrotti, DPT

• Physical Therapy Clinic/Center in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Physical Therapy Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2008; 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.