Active NPI
Mark Douglas Carter
- Physical Therapy Assistant
- Snellville, GA
National Provider Identifier
1780168674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA003787
- Practice address
- 2346 Wisteria Dr Ste 110
Snellville, GA 30078-6174 - Phone
- (678) 701-2225
- NPI assigned
- Sep 18, 2018
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA003787 | GA | Primary |
Addresses
Primary practice location
2346 Wisteria Dr Ste 110
Snellville, GA 30078-6174
Mailing address
170 Forrest Lake Rd
Alpharetta, GA 30022-1009
Phone (678) 910-8533
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA003787 | GA | MD | Physical Therapy Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aica Orthopedics, P. C. | Past | Accepting new patients | |
| Aica Orthopedics, P.C. | Past | Accepting new patients | |
| Aica Orthopedics, P. C. | Past | Accepting new patients | |
| Aica Orthopedics, P.C. | Past | Accepting new patients | |
| Aica Orthopedics, P.C. | Past | Accepting new patients |
Organizations & group practices 5
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.
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- Clinic/Center
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-
- Multi-Specialty Clinic/Center
- Kennesaw, GA
- NPI 1730532698
-
- Multi-Specialty Clinic/Center
- Jonesboro, GA
- NPI 1679737001
-
- Multi-Specialty Clinic/Center
- Lithia Springs, GA
- NPI 1740692342
-
- Clinic/Center
- Atlanta, GA
- NPI 1841708682
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1537228800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1537228800000",
"number": "1780168674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "170 FORREST LAKE RD",
"city": "ALPHARETTA",
"state": "GA",
"postal_code": "300221009",
"telephone_number": "678-910-8533"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2346 WISTERIA DR STE 110",
"city": "SNELLVILLE",
"state": "GA",
"postal_code": "300786174",
"telephone_number": "678-701-2225"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CARTER",
"first_name": "MARK",
"middle_name": "DOUGLAS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-09-18",
"last_updated": "2018-09-18",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "GA",
"license": "PTA003787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Snellville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.