NPIMap

Organization Active NPI

Independent Physical Therapy of Georgia, LLC

  • Physical Therapy Clinic/Center
  • Atlanta, GA
National Provider Identifier
1780947978
Registry record updated Aug 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC
Practice address
2255 Peachtree Rd NE
Ste G
Atlanta, GA 30309-1101
Phone
(404) 351-3257
Fax
(404) 351-3896
NPI assigned
Jun 21, 2012
Last updated
Aug 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 10, 2012

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

Authorized official

Name
Kiley Russell
Title
Manager
Phone
(423) 238-8923

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Specialty Clinic/Center 261QM2500X NU
Physical Therapy Clinic/Center 261QP2000X NU Primary
Occupational Medicine Clinic/Center 261QX0100X NU

Addresses

Primary practice location

2255 Peachtree Rd NE
Ste G
Atlanta, GA 30309-1101

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

National Provider Directory

National Provider Directory
Tax ID family
Independent Phys Therapy161 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

2255 Peachtree Rd NE
Ste G
Atlanta, GA 30309
Phone (404) 351-3257

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1340236800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1344556800000",
    "number": "1780947978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2255 PEACHTREE RD NE",
            "address_2": "STE G",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091101",
            "telephone_number": "404-351-3257",
            "fax_number": "404-351-3896"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-06-21",
        "last_updated": "2012-08-10",
        "status": "A",
        "authorized_official_last_name": "RUSSELL",
        "authorized_official_first_name": "KILEY",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "423-238-8923"
    },
    "taxonomies": [
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2012; 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.