Renascent Physical Therapy LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

RENASCENT PHYSICAL THERAPY LLC

Practice address

523 Lemon St NE
Marietta, GA 30060-1723

Phone

(770) 527-9440

NPI assigned

Feb 9, 2024

Organization subpart

No

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

Authorized official

Name

Jacqueline Guthrie, PTNPI 1487826475

Title

PT/Manager

Phone

(770) 527-9440

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jacqueline Ann-Marie Guthrie, PT

  • Physical Therapist
  • Marietta, GA
  • NPI 1487826475
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1707436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1709164800000",
    "number": "1750145793",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "523 LEMON ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601723",
            "telephone_number": "770-527-9440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "523 LEMON ST NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601723",
            "telephone_number": "770-527-9440"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENASCENT PHYSICAL THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-09",
        "last_updated": "2024-02-29",
        "certification_date": "2024-02-29",
        "status": "A",
        "authorized_official_last_name": "GUTHRIE",
        "authorized_official_first_name": "JACQUELINE",
        "authorized_official_title_or_position": "PT/MANAGER",
        "authorized_official_telephone_number": "770-527-9440",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Marietta, GA
• Providers in Marietta, GA by specialty
• Physical Therapy Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 29, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.