Individual provider Active NPI

Brian Justin Wechter, DPT

  • Physical Therapist
  • Gainesville, GA
National Provider Identifier
1760639207
Registry record updated Aug 27, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT006988 Issued in GA
Practice address
1240 Jesse Jewell Pkwy SE
Suite 500
Gainesville, GA 30501-3862
Phone
(770) 536-9864
Fax
(770) 297-5023
NPI assigned
Aug 27, 2008
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT006988 GA Primary

Addresses

Primary practice location

1240 Jesse Jewell Pkwy SE
Suite 500
Gainesville, GA 30501-3862

Mailing address

1240 Jesse Jewell Pkwy SE
Suite 500
Gainesville, GA 30501-3862
Phone (770) 536-9864

Other identifiers 1

IdentifierTypeStateIssuer
PT006988OtherGAPT LICENSE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20081105000445 GA Practitioner - Physical Therapist in Private Practice 2961561931 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Medical College of Georgia School of Medicine, 2000
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Esop Rehabilitation LLC 224 clinicians

Practice addresses (Care Compare)

11242 Cumming Hwy
Suite 105
Canton, GA 30115-8155
Phone (770) 720-7156

875 Flat Shoals Rd SE
Suite 150
Conyers, GA 30094-6640
Phone (770) 785-7669

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
HHS exclusion list flag
Flagged The directory lists this NPI on an HHS exclusion list. Confirm with the OIG exclusions search.

State licenses

LicenseStateTypeSpecialty
PT006988GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Esop Rehabilitation, LLC Physical Therapist CurrentSince Aug 16, 2024 Accepting new patients
Esop Rehabilitation LLC Physical Therapist Current Accepting new patients
Esop Rehabilitation, LLC Physical Therapist CurrentSince Aug 16, 2024 Accepting new patients
Northeast Georgia Diagnostic Associates and Clinic, LLC CurrentSince Oct 1, 2018 Accepting new patients

Locations

11242 Cumming Hwy
Ste 105
Canton, GA 30115
Phone (770) 720-7156

875 Flat Shoals Rd SE
Ste 150
Conyers, GA 30094
Phone (770) 785-7669

1250 Jesse Jewell Pkwy SE
Ste 400
Gainesville, GA 30501
Phone (470) 228-7507

1240 Jesse Jewell Pkwy SE
Ste 500
Gainesville, GA 30501

Organizations & group practices 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1219795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219795200000",
    "number": "1760639207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE",
            "address_2": "SUITE 500",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013862",
            "telephone_number": "770-536-9864",
            "fax_number": "770-297-5023"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1240 JESSE JEWELL PKWY SE",
            "address_2": "SUITE 500",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013862",
            "telephone_number": "770-536-9864",
            "fax_number": "770-297-5023"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WECHTER",
        "first_name": "BRIAN",
        "middle_name": "JUSTIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-27",
        "last_updated": "2008-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT006988",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PT LICENSE",
            "identifier": "PT006988",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2008; 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.

Verify at the official NPI Registry.