Active NPI
Daniel Wallace Mackie, P.T., D.P.T., O.C.S.
- Physical Therapist
- Canton, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT009812
- Practice address
- 6768 Hickory Flat Hwy
Ste 110
Canton, GA 30115-9376 - Phone
- (770) 721-5767
- Fax
- (770) 345-0158
- NPI assigned
- Oct 22, 2009
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT009812 | GA | Primary |
Addresses
Primary practice location
6768 Hickory Flat Hwy
Ste 110
Canton, GA 30115-9376
Mailing address
1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 497-0005
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2009
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1025 E W Connector
Suite 406
Austell, GA 30106-8531
Phone (770) 384-1001
6768 Hickory Flat Hwy
Suite 110
Canton, GA 30115-9376
Phone (770) 721-5767
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT009812 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Agilitas USA, Inc | Physical Therapist | Current | Accepting new patients |
| Independent Physical Therapy of Georgia, LLC | Physical Therapist | Current | Accepting new patients |
| Agilitas USA Inc | Physical Therapist | Current | Accepting new patients |
| Independent Physical Therapy of Georgia, LLC | Physical Therapist | Current | 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
6768 Hickory Flat Hwy
Ste 110
Canton, GA 30115
Phone (770) 704-8244
11490 Alpharetta Hwy
Ste 200
Roswell, GA 30076
Phone (770) 740-8592
6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923
8823 Production Ln
Ooltewah, TN 37363
Phone (423) 238-8923
Organizations & group practices 4
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Fort Oglethorpe, GA
- NPI 1780636068
-
- Occupational Therapist
- Gainesville, GA
- NPI 1306013941
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1256169600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742515200000",
"number": "1851627079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 CORPORATE DR STE 400",
"city": "HOOVER",
"state": "AL",
"postal_code": "352425424",
"telephone_number": "423-497-0005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6768 HICKORY FLAT HWY",
"address_2": "STE 110",
"city": "CANTON",
"state": "GA",
"postal_code": "301159376",
"telephone_number": "770-721-5767",
"fax_number": "770-345-0158"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MACKIE",
"first_name": "DANIEL",
"middle_name": "WALLACE",
"credential": "P.T., D.P.T., O.C.S.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2009-10-22",
"last_updated": "2025-03-21",
"certification_date": "2025-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT009812",
"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 Mar 21, 2025; 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.