Pro-Fit Rehab and Sports Medicine

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PRO-FIT REHAB AND SPORTS MEDICINE

Doing business as

Advanced Physical Therapy and Sports Medicine
Advanced Physical Therapy and Sports Medicine Clinic

Practice address

7342 Stonecrest Concourse
Suite a
Stonecrest, GA 30038-6989

Phone

(678) 526-5400

Fax

(678) 669-6222

NPI assigned

Apr 10, 2007

Last updated

Oct 3, 2019By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Damon S Williams, DPT

Title

Ceo

Phone

(678) 526-5400

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 2

• Advanced Physical Therapy and Sports Medicine Doing business as
• Advanced Physical Therapy and Sports Medicine Clinic Doing business as

Locations

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

{
    "created_epoch": "1176163200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1570060800000",
    "number": "1740403625",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7342 STONECREST CONCOURSE",
            "address_2": "SUITE A",
            "city": "STONECREST",
            "state": "GA",
            "postal_code": "300386989",
            "telephone_number": "678-526-5400",
            "fax_number": "678-669-6222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7342 STONECREST CONCOURSE",
            "address_2": "SUITE A",
            "city": "STONECREST",
            "state": "GA",
            "postal_code": "300386989",
            "telephone_number": "678-526-5400",
            "fax_number": "678-669-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRO-FIT REHAB AND SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-10",
        "last_updated": "2019-10-03",
        "status": "A",
        "authorized_official_last_name": "WILLIAMS",
        "authorized_official_first_name": "DAMON",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-526-5400",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "990772198B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Physical Therapy and Sports Medicine",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Physical Therapy and Sports Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Advanced Physical Therapy and Sports Medicine Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2019; 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.