Stephanie Burst Wotiz, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT014228 Issued in GA

Practice address

930 Woodstock Rd Ste 310
Roswell, GA 30075-2220

Phone

(770) 998-6636

NPI assigned

Aug 12, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Synapse Neurorehab and Wellness LLCGroup PAC ID 1355742917, 13 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Synapse Neurorehab and Wellness LLC

  • Physical Therapist
  • Sandy Springs, GA
  • NPI 1679156863
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1565568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565568000000",
    "number": "1700432283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3286 LANTERN COACH LN NE",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300753164",
            "telephone_number": "404-388-8177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "930 WOODSTOCK RD STE 310",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300752220",
            "telephone_number": "770-998-6636"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOTIZ",
        "first_name": "STEPHANIE",
        "middle_name": "BURST",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-12",
        "last_updated": "2019-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sheila Woodall, MS
• Shirley Woods-Witcher
• Kenwanna Woods, RBT
• Madison Lee Woody, PT, DPT
• Kimberly E Wootton, OT
• Christopher Campbell Wray, PHARM. D.
• Wright Physical Therapy and Wellness, LLC
• Brian Wright, DPT
• Tracy Ann Wright, P.T.
• Wendi Patice Wright

• Physical Therapist in Roswell, GA
• Providers in Roswell, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.