NPIMap

Organization Active NPI

Southern Pelvic Therapy LLC

  • Physical Therapist
  • Moultrie, GA
National Provider Identifier
1780579045
Registry record updated Jun 9, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SOUTHERN PELVIC THERAPY LLC
Practice address
250 Doc Darbyshire Rd Ste 9
Moultrie, GA 31788-4168
Phone
(229) 502-9788
Fax
(229) 217-4910
NPI assigned
Jun 9, 2025
Last updated
Jun 9, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2025

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

Authorized official

Name
Patricia Sutherland
Title
Provider Enrollment
Phone
(229) 891-9131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X Primary

Addresses

Primary practice location

250 Doc Darbyshire Rd Ste 9
Moultrie, GA 31788-4168

Mailing address

PO Box 1266
Moultrie, GA 31776-1266
Phone (229) 502-9788

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1749427200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749427200000",
    "number": "1780579045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1266",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317761266",
            "telephone_number": "229-502-9788",
            "fax_number": "229-217-4910"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 DOC DARBYSHIRE RD STE 9",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317884168",
            "telephone_number": "229-502-9788",
            "fax_number": "229-217-4910"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN PELVIC THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-09",
        "last_updated": "2025-06-09",
        "certification_date": "2025-06-09",
        "status": "A",
        "authorized_official_last_name": "SUTHERLAND",
        "authorized_official_first_name": "PATRICIA",
        "authorized_official_title_or_position": "PROVIDER ENROLLMENT",
        "authorized_official_telephone_number": "229-891-9131"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Moultrie, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2025; 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.