NPIMap

Organization Active NPI

Georgia Physical Therapy & Sports Medicine Center

  • Physical Therapist
  • Alpharetta, GA
National Provider Identifier
1790898617
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT006448 Issued in GA
Legal business name
GEORGIA PHYSICAL THERAPY & SPORTS MEDICINE CENTER
Practice address
6495 Shiloh Rd
Suite 100
Alpharetta, GA 30005
Phone
(770) 888-3011
NPI assigned
Aug 16, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Chad R Luth, P.T.NPI 1023027018
Title
President
Phone
(770) 880-3011

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)CodeLicenseStatePrimary
Physical Therapist 225100000X PT006448 GA Primary

Addresses

Primary practice location

6495 Shiloh Rd
Suite 100
Alpharetta, GA 30005

Mailing address

6495 Shiloh Rd
Suite 100
Alpharetta, GA 30005
Phone (770) 888-3011

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20070309000338 GA Part B Supplier - Clinic/Group Practice 0941303028 Receives reassigned benefits from 7 practitioners
Practice locations: Alpharetta, GA; Canton, GA

National Provider Directory

National Provider Directory
Tax ID family
Georgia Physical Therapy Sports Medicine Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 7

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": "1155686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1790898617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6495 SHILOH RD",
            "address_2": "SUITE 100",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30005",
            "telephone_number": "770-888-3011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6495 SHILOH RD",
            "address_2": "SUITE 100",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "30005",
            "telephone_number": "770-888-3011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA PHYSICAL THERAPY & SPORTS MEDICINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-16",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "LUTH",
        "authorized_official_first_name": "CHAD",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-880-3011",
        "authorized_official_credential": "P.T."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT006448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.

Verify at the official NPI Registry.