NPIMap

Organization Active NPI

Physio

  • Physical Therapy Clinic/Center
  • Dacula, GA
National Provider Identifier
1801272273
Registry record updated Aug 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
012019 Issued in GA
Legal business name
PHYSIO
Practice address
3605 Braselton Hwy
Suite 101
Dacula, GA 30019-4666
Phone
(770) 904-0772
NPI assigned
Aug 7, 2015
Last updated
Aug 7, 2015By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 7, 2015

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

Authorized official

Name
Dr. David William Newsome Jr., DPTNPI 1174990295
Title
Physical Therapist
Phone
(336) 782-7461

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 012019 GA Primary

Addresses

Primary practice location

3605 Braselton Hwy
Suite 101
Dacula, GA 30019-4666

Mailing address

3605 Braselton Hwy
Suite 101
Dacula, GA 30019-4666

National Provider Directory

National Provider Directory
Tax ID family
Physiotherapy Assoc Can300 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 17

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

View all 17

Locations

3605 Braselton Hwy
Ste 101
Dacula, GA 30019
Phone (678) 804-7430

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": "1438905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1438905600000",
    "number": "1801272273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3605 BRASELTON HWY",
            "address_2": "SUITE 101",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300194666"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3605 BRASELTON HWY",
            "address_2": "SUITE 101",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300194666",
            "telephone_number": "770-904-0772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSIO",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-07",
        "last_updated": "2015-08-07",
        "status": "A",
        "authorized_official_last_name": "NEWSOME",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "336-782-7461",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "GA",
            "license": "012019",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2015; 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.