Individual provider Active NPI

Mariat Thankachan, PT

  • Physical Therapist
  • Columbus, GA
National Provider Identifier
1720815319
Registry record updated Sep 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT017413 Issued in GA
Practice address
106 Enterprise CT Ste C
Columbus, GA 31904-9096
Phone
(706) 221-6448
Fax
(706) 365-0002
NPI assigned
Sep 17, 2024
Last updated
Sep 17, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT017413 GA Primary

Addresses

Primary practice location

106 Enterprise CT Ste C
Columbus, GA 31904-9096

Mailing address

1650 Lyndon Farm CT Ste 300
Louisville, KY 40223-5005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241207000195 GA Practitioner - Physical Therapist in Private Practice 6901332428 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Mercer University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Horizons Diagnostics, L.L.C.Group PAC ID 1951399724, 24 clinicians

Practice addresses (Care Compare)

106 Enterprise CT
Suite a
Columbus, GA 31904-9096
Phone (706) 321-2555

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT017413GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Human Performance and Rehabilitation Centers, LLC Physical Therapist CurrentSince Aug 24, 2024 Accepting new patients
Horizons Diagnostics, L.L.C. CurrentSince Sep 25, 2024 Accepting new patients
Horizons Diagnostics, L.L.C. CurrentSince Sep 25, 2024 Accepting new patients
Human Performance and Rehabilitation Centers LLC CurrentSince Aug 24, 2024 Accepting new patients

Locations

788 Prince Ave
Ste C
Athens, GA 30606
Phone (706) 453-2111

106 Enterprise Ct
Ste A
Columbus, GA 31904
Phone (706) 321-2555

106 Enterprise Ct
Ste C
Columbus, GA 31904
Phone (706) 221-6448

3934 Woodruff Rd
Columbus, GA 31904
Phone (706) 321-0476

6298 Veterans Pkwy
Ste 5A
Columbus, GA 31909
Phone (706) 320-0927

1650 Lyndon Farm Ct
Ste 300
Louisville, KY 40223
Phone (726) 202-3039

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/FDJDBA

Organizations & group practices 4

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": "1726531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726531200000",
    "number": "1720815319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "106 ENTERPRISE CT STE C",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319049096",
            "telephone_number": "706-221-6448",
            "fax_number": "706-365-0002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THANKACHAN",
        "first_name": "MARIAT",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-17",
        "last_updated": "2024-09-17",
        "certification_date": "2024-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT017413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2024; 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.