Individual provider Active NPI

Karla C. Baumgartner, PTA

  • Physical Therapy Assistant
  • Conyers, GA
National Provider Identifier
1720597669
Registry record updated Sep 22, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
PTA003855 Issued in GA
Practice address
1680 Highway 138 SE
Conyers, GA 30013-1281
Phone
(770) 760-0066
Fax
(770) 922-7599
NPI assigned
Sep 22, 2017
Last updated
Sep 22, 2017By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 22, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X PTA003855 GA Primary

Addresses

Primary practice location

1680 Highway 138 SE
Conyers, GA 30013-1281

Mailing address

132 Wood Lake Dr Apt 535
Athens, GA 30606-6962
Phone (706) 224-2283

Other identifiers 1

IdentifierTypeStateIssuer
840M83182OtherGABLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PTA003855GAMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Occupational Health Centers of Georgia PC Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1506038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1506038400000",
    "number": "1720597669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "132 WOOD LAKE DR APT 535",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306066962",
            "telephone_number": "706-224-2283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1680 HIGHWAY 138 SE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300131281",
            "telephone_number": "770-760-0066",
            "fax_number": "770-922-7599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAUMGARTNER",
        "first_name": "KARLA",
        "middle_name": "C.",
        "name_prefix": "Ms.",
        "credential": "PTA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-22",
        "last_updated": "2017-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "PTA003855",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "840M83182",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2017; 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.