Nathaniel J Malo, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT015742 Issued in GA

Practice address

4216 Washington Rd Ste 2
Evans, GA 30809-4717

Phone

(706) 814-5460

Fax

(706) 814-5574

NPI assigned

Oct 6, 2011

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Central Coast Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Paso Robles, CA
  • NPI 1558678169
  NPD
• Gold Country Therapies, Inc

  • Physical Therapy Clinic/Center
  • Valley Springs, CA
  • NPI 1447658067
  NPD (past)

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

{
    "created_epoch": "1317859200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656633600000",
    "number": "1730463993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5718",
            "city": "KALISPELL",
            "state": "MT",
            "postal_code": "599035718",
            "telephone_number": "406-756-0134",
            "fax_number": "406-300-1612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4216 WASHINGTON RD STE 2",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094717",
            "telephone_number": "706-814-5460",
            "fax_number": "706-814-5574"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALO",
        "first_name": "NATHANIEL",
        "middle_name": "J",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-10-06",
        "last_updated": "2022-07-01",
        "certification_date": "2022-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT015742",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "PT 38220",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alexandra Marie Maas, DC
• Abigail Macdonald
• Larissa Illyn Mackert, M.ED., APC, NCC
• Sara Mahmoud
• Levi Hankwale Makala, DVM, MBA, MAT, PHD
• Lillian Mann
• Logan Taylor Manning
• Andrea Lynn Manus, LCSW
• Mark a Benak MD PC
• Rachel S Marshall, PHRMD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2022; 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.