Thai Thanh Khuong, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT015321 Issued in GA

Practice address

1670 McKendree Church Rd Ste 40
Lawrenceville, GA 30043-4100

Phone

(678) 257-4037

Fax

(678) 819-7536

NPI assigned

Jun 30, 2021

Last updated

Jun 30, 2021By the provider in NPPES

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1710557970",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1670 MCKENDREE CHURCH RD STE 40",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434100",
            "telephone_number": "678-257-4037",
            "fax_number": "678-819-7536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1670 MCKENDREE CHURCH RD STE 40",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300434100",
            "telephone_number": "678-257-4037",
            "fax_number": "678-819-7536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHUONG",
        "first_name": "THAI",
        "middle_name": "THANH",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT015321",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2021; 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.