Proactive Physical Therapy, Inc.

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT008404 Issued in GA

Legal business name

PROACTIVE PHYSICAL THERAPY, INC.

Practice address

4625 Alexander Dr
Suite 115
Alpharetta, GA 30022-3719

Phone

(404) 247-0174

NPI assigned

Jan 17, 2009

Last updated

Jan 17, 2009By 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

Mrs. Angela Nicole Fowler, PT

Title

Owner/PT

Phone

(404) 247-0174

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Angela Nicole Nix, PT

  • Orthopedic Physical Therapist
  • Canton, GA
  • NPI 1053563601
  NPD

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

{
    "created_epoch": "1232150400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232150400000",
    "number": "1750528303",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1360 BELLSMITH DR",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300760915",
            "telephone_number": "404-247-0174"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4625 ALEXANDER DR",
            "address_2": "SUITE 115",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300223719",
            "telephone_number": "404-247-0174"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE PHYSICAL THERAPY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-17",
        "last_updated": "2009-01-17",
        "status": "A",
        "authorized_official_last_name": "FOWLER",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "NICOLE",
        "authorized_official_title_or_position": "OWNER/PT",
        "authorized_official_telephone_number": "404-247-0174",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "GA",
            "license": "PT008404",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapy Clinic/Center in Alpharetta, GA
• Providers in Alpharetta, 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 Jan 17, 2009; 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.