Individual provider Active NPI

William Greer Bankhead III, PT, DPT

  • Physical Therapist
  • Canton, GA
National Provider Identifier
1841754496
Registry record updated Jul 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT013523 Issued in GA
Practice address
1453 Riverstone Pkwy Ste 170
Canton, GA 30114-5603
Phone
(770) 704-0774
Fax
(770) 704-0779
NPI assigned
Jan 29, 2019
Last updated
Jul 3, 2019By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 3, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PY34079 FL
Physical Therapist 225100000X PT013523 GA Primary

Addresses

Primary practice location

1453 Riverstone Pkwy Ste 170
Canton, GA 30114-5603

Mailing address

6397 Lee Hwy Ste 300
Chattanooga, TN 37421-4915
Phone (423) 238-7217

Other practice location 1

1 University Blvd
St Augustine, FL 32086-5799
Phone (904) 829-3411

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190812001491 GA Practitioner - Physical Therapist in Private Practice 3274860499 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1453 Riverstone Pkwy
Suite 170
Canton, GA 30114-5603
Phone (770) 704-0774

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PY34079FLMDPhysical Therapist
PT013523GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy, Inc CurrentSince Jul 22, 2024 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jul 15, 2019 Accepting new patients
Benchmark Physical Therapy Inc Physical Therapist CurrentSince Jul 22, 2024 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Nov 1, 2024 Accepting new patients
Independent Physical Therapy of Ga, LLC Physical Therapist CurrentSince Jul 15, 2019 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist Current Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Nov 1, 2024 Accepting new patients
First Coast Physical Therapy Inc Physical Therapist PastSince Aug 26, 2008 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

1453 Riverstone Pkwy
Ste 170
Canton, GA 30114
Phone (770) 704-0077

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

3460 Sandy Plains Rd
Unit 610
Marietta, GA 30066
Phone (678) 631-5878

2295 Towne Lake Pkwy
Ste 148
Woodstock, GA 30189
Phone (770) 926-2744

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1548720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562112000000",
    "number": "1841754496",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214915",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1453 RIVERSTONE PKWY STE 170",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145603",
            "telephone_number": "770-704-0774",
            "fax_number": "770-704-0779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1 University Blvd",
            "address_purpose": "LOCATION",
            "city": "St Augustine",
            "state": "FL",
            "postal_code": "320865799",
            "country_code": "US",
            "telephone_number": "904-829-3411",
            "fax_number": "904-829-3412",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BANKHEAD",
        "first_name": "WILLIAM",
        "middle_name": "GREER",
        "name_suffix": "III",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-29",
        "last_updated": "2019-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PY34079",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT013523",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.