NPIMap

Organization Active NPI

Emory Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Brookhaven, GA
National Provider Identifier
1720097561
Registry record updated Mar 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
EMORY PHYSICAL THERAPY, LLC
Practice address
1968 Hawks LN NE Ste 160
Brookhaven, GA 30329-2283
Phone
(404) 251-2537
Fax
(404) 251-2499
NPI assigned
Aug 7, 2006
Last updated
Mar 11, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2025

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

Authorized official

Name
Greg Cooper
Title
Managing Partner
Phone
(219) 365-6560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1968 Hawks LN NE Ste 160
Brookhaven, GA 30329-2283

Mailing address

8259 Wicker Ave
Saint John, IN 46373-8878

Other practice location 1

59 Executive Drive South
Suite 1100
Atlanta, GA 30329-2208
Phone (404) 778-6330

Other practice location 2

21 Ortho Ln
Atlanta, GA 30329-2315
Phone (404) 778-3350

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041019000776 GA Part B Supplier - Clinic/Group Practice 1153382676 Receives reassigned benefits from 310 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jonesboro, GA; Tucker, GA; Smyrna, GA; Lithonia, GA; Lagrange, GA; Johns Creek, GA; Flowery Branch, GA; Dunwoody, GA…

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory

Member of 2

Organizations this organization is a member of, according to the National Provider Directory.

Locations

59 Executive Park South NE
Ste 1100
Atlanta, GA 30329
Phone (404) 778-6330

1014 Sycamore Dr
Decatur, GA 30030
Phone (404) 251-2007

2021 Pernoshal Ct
Ste 2200
Dunwoody, GA 30338
Phone (404) 778-6031

7813 Spivey Station Blvd
Ste 230
Jonesboro, GA 30236
Phone (404) 251-2458

Practitioners & affiliated clinicians

Practitioners 300

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 300

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741651200000",
    "number": "1720097561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8259 WICKER AVE",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463738878"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1968 HAWKS LN NE STE 160",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303292283",
            "telephone_number": "404-251-2537",
            "fax_number": "404-251-2499"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "59 Executive Drive South",
            "address_2": "Suite 1100",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303292208",
            "country_code": "US",
            "telephone_number": "404-778-6330",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "21 Ortho Ln",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303292315",
            "country_code": "US",
            "telephone_number": "404-778-3350",
            "fax_number": "404-778-3185",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EMORY PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-07",
        "last_updated": "2025-03-11",
        "certification_date": "2025-03-11",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "GREG",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "219-365-6560"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brookhaven, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 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.