Active NPI
Summit Physical Therapy
- Physical Therapist
- Perry, GA
National Provider Identifier
1770014409
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 16106467
- Legal business name
- SUMMIT PHYSICAL THERAPY
- Practice address
- 1306 Macon Rd
Perry, GA 31069-2652 - Phone
- (478) 987-4600
- Fax
- (844) 308-4986
- NPI assigned
- Mar 24, 2017
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Spencer Shugart
- Title
- Ceo
- Phone
- (478) 957-1491
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 16106467 | GA | Primary |
Addresses
Primary practice location
1306 Macon Rd
Perry, GA 31069-2652
Mailing address
1306 Macon Rd
Perry, GA 31069-2652
Phone (478) 987-4600
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
1306 Macon Rd
Perry, GA 31069
Phone (478) 987-1441
1202 Macon Rd
Perry, GA 31069
Phone (478) 987-4600
Practitioners & affiliated clinicians
Practitioners 3
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1490313600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1660780800000",
"number": "1770014409",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1306 MACON RD",
"city": "PERRY",
"state": "GA",
"postal_code": "310692652",
"telephone_number": "478-987-4600",
"fax_number": "844-308-4986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1306 MACON RD",
"city": "PERRY",
"state": "GA",
"postal_code": "310692652",
"telephone_number": "478-987-4600",
"fax_number": "844-308-4986"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "SUMMIT PHYSICAL THERAPY",
"organizational_subpart": "NO",
"enumeration_date": "2017-03-24",
"last_updated": "2022-08-18",
"certification_date": "2022-08-18",
"status": "A",
"authorized_official_last_name": "SHUGART",
"authorized_official_first_name": "SPENCER",
"authorized_official_title_or_position": "CEO",
"authorized_official_telephone_number": "478-957-1491"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": "GA",
"license": "16106467",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Perry, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2022; 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.