Active NPI
Mariat Thankachan, PT
- Physical Therapist
- Columbus, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT017413
- 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, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
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
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT017413 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Human Performance and Rehabilitation Centers, LLC | Physical Therapist | Current | Accepting new patients |
| Horizons Diagnostics, L.L.C. | Current | Accepting new patients | |
| Horizons Diagnostics, L.L.C. | Current | Accepting new patients | |
| Human Performance and Rehabilitation Centers LLC | Current | 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
- 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.
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- NPI 1366443368
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- Physical Therapist
- Columbus, GA
- NPI 1104415983
-
- Durable Medical Equipment & Medical Supplies
- Columbus, GA
- NPI 1891583654
-
- Specialist
- Opelika, AL
- NPI 1346685765
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.