Southern Crescent Physical Therapy

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

002989 Issued in GA

Legal business name

SOUTHERN CRESCENT PHYSICAL THERAPY

Practice address

155 Carnegie PL
Fayetteville, GA 30214-3981

Phone

(770) 716-9121

Fax

(770) 716-2474

NPI assigned

Dec 15, 2008

Last updated

Dec 15, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Linda Sue Theriac

Title

Office Manager

Phone

(770) 716-9121

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 3

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.

• Aaron L. Adams, RPT

  • Physical Therapist
  • Fayetteville, GA
  • NPI 1225147820
  Medicare reassignment Care Compare group NPD
• Justin Thomas Cox, DC

  • Chiropractor
  • Fayetteville, GA
  • NPI 1649816406

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Christal Love, LMT

  • Massage Therapist
  • Fayetteville, GA
  • NPI 1427308378
  NPD (past)

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

{
    "created_epoch": "1229299200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1229299200000",
    "number": "1801031232",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "155 CARNEGIE PL",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302143981",
            "telephone_number": "770-716-9121",
            "fax_number": "770-716-2474"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 CARNEGIE PL",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302143981",
            "telephone_number": "770-716-9121",
            "fax_number": "770-716-2474"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN CRESCENT PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-15",
        "last_updated": "2008-12-15",
        "status": "A",
        "authorized_official_last_name": "THERIAC",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "SUE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "770-716-9121",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "GA",
            "license": "002989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Atlanta Surgical Assistants
• South Regional Surgical Services
• Southeast Georgia Injury Centers
• Southern Behavioral Healthcare,P.C
• Southern Crescent Neurological Clinic,PC
• Southern Crescent Physicians Group, Inc.
• Southern Crescent Women's Healthcare PC
• Southern Neighbor Medical Transport LLC
• Southern Pain Institute P C (Parish Pharmacy)
• Southern Roots ABA LLC

• Physical Therapy Clinic/Center in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Physical Therapy Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2008; 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.