NPIMap

Organization Active NPI

Emory Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Atlanta, GA
National Provider Identifier
1821760976
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
EMORY PHYSICAL THERAPY, LLC
Practice address
21 Ortho LN
Atlanta, GA 30329-2315
Phone
(404) 778-6390
NPI assigned
Sep 28, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Authorized official

Name
Gregory L Cooper
Title
Managing Partner
Phone
(219) 365-6560

Specialties & licenses 1

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

Addresses

Primary practice location

21 Ortho LN
Atlanta, GA 30329-2315

Mailing address

PO Box 102831
Atlanta, GA 30368-2831
Phone (404) 251-2007

Other identifiers 1

IdentifierTypeStateIssuer
GRP6756OtherGAMEDICARE PTAN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041019000776 GA Part B Supplier - Clinic/Group Practice 1153382676 Receives reassigned benefits from 310 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jonesboro, GA; Tucker, GA; Smyrna, GA; Lithonia, GA; Lagrange, GA; Johns Creek, GA; Flowery Branch, GA; Dunwoody, GA…

Other NPIs on the same Medicare enrollment 14

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Emory Physical Therapy LLC14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

Locations

1968 Hawks Ln NE
Brookhaven, GA 30329
Phone (404) 251-2537

Practitioners & affiliated clinicians

Practitioners 5

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

NPI Registry JSON

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

{
    "created_epoch": "1632787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1632787200000",
    "number": "1821760976",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 102831",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303682831",
            "telephone_number": "404-251-2007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 ORTHO LN",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292315",
            "telephone_number": "404-778-6390"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMORY PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-10",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "authorized_official_telephone_number": "219-365-6560"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN",
            "identifier": "GRP6756",
            "state": "GA"
        }
    ],
    "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 Sep 28, 2021; 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.