Medventures Physical Therapy, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

6464 Issued in GA

Legal business name

MEDVENTURES PHYSICAL THERAPY, LLC

Practice address

1075 Lafayette Parkway
Ste 220
Lagrange, GA 30241

Phone

(706) 845-9370

Fax

(706) 845-9371

NPI assigned

May 17, 2016

Organization subpart

No

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

Authorized official

Name

Mrs. Lisa Stephens

Title

Authorized Official

Phone

(706) 350-1338

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Davin Mitchell, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Lagrange, GA
  • NPI 1861669517
  NPD (past)

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

{
    "created_epoch": "1463443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1504656000000",
    "number": "1851748172",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1075 LAFAYETTE PARKWAY",
            "address_2": "STE 220",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "30241",
            "telephone_number": "706-350-1338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1075 LAFAYETTE PARKWAY",
            "address_2": "STE 220",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "30241",
            "telephone_number": "706-845-9370",
            "fax_number": "706-845-9371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDVENTURES PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-17",
        "last_updated": "2017-09-06",
        "status": "A",
        "authorized_official_last_name": "STEPHENS",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "706-350-1338",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "6464",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Denise McMickin
• Darrell L McMullen Sr., CASE MANAGER
• Keisha McNeill, MS, LPC
• Med Ventures MRI, LLC
• Medical Care of Lagrange, LLC
• Erin Meeks, MD
• Ryan Meeks, PHARMD
• Mental Health Services of Georgia
• Jessica Teara Meriwether, LPC
• Stephanie Ruth Mezick

• Physical Therapist in Lagrange, GA
• Providers in Lagrange, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2017; 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.