NPIMap

Organization Active NPI

Van Varick Pediatric Physical Therapy

  • Pediatric Physical Therapist
  • Roswell, GA
National Provider Identifier
1821464124
Registry record updated Aug 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
License
PT012056 Issued in GA
Legal business name
VAN VARICK PEDIATRIC PHYSICAL THERAPY
Practice address
1000 Holcomb Woods Pkwy
Suite 422
Roswell, GA 30076-2575
Phone
(770) 641-8070
NPI assigned
Aug 20, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2015

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

Authorized official

Name
Elizabeth Saint John, DPT
Title
Cfo
Phone
(561) 707-5209

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X PT012056 GA
Pediatric Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251P0200X PT012056 GA Primary

Addresses

Primary practice location

1000 Holcomb Woods Pkwy
Suite 422
Roswell, GA 30076-2575

Mailing address

1000 Holcomb Woods Pkwy
Suite 422
Roswell, GA 30076-2575

National Provider Directory

National Provider Directory

Locations

1000 Holcomb Woods Pkwy
Ste 422
Roswell, GA 30076
Phone (770) 641-8070

Practitioners & affiliated clinicians

Practitioners 14

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1440028800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440028800000",
    "number": "1821464124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1000 HOLCOMB WOODS PKWY",
            "address_2": "SUITE 422",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300762575"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 HOLCOMB WOODS PKWY",
            "address_2": "SUITE 422",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300762575",
            "telephone_number": "770-641-8070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "VAN VARICK PEDIATRIC PHYSICAL THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-20",
        "last_updated": "2015-08-20",
        "status": "A",
        "authorized_official_last_name": "SAINT JOHN",
        "authorized_official_first_name": "ELIZABETH",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "561-707-5209",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012056",
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": "GA",
            "license": "PT012056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 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.