Individual provider Active NPI

Phillip Daniel Loudermilk, PT, DPT

  • Physical Therapist
  • Woodstock, GA
National Provider Identifier
1871070359
Registry record updated Jul 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
2295 Towne Lake Pkwy Ste 148
Woodstock, GA 30189-5520
Phone
(770) 926-2744
Fax
(770) 926-2794
NPI assigned
Jul 26, 2018
Last updated
Jul 26, 2018By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 26, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X GA Primary

Addresses

Primary practice location

2295 Towne Lake Pkwy Ste 148
Woodstock, GA 30189-5520

Mailing address

6397 Lee Hwy Ste 300
Chattanooga, TN 37421-2564
Phone (423) 238-7217

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181106000025 GA Practitioner - Physical Therapist in Private Practice 1254684418 Reassigns benefits to 2 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)

2800 Buford Dr
Suite 315
Buford, GA 30519-5107
Phone (678) 450-9933

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Rehabilitation and Performance Center CurrentSince Nov 16, 2020 Accepting new patients
Independent Physical Therapy of Georgia, LLC CurrentSince Sep 7, 2018 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Sep 7, 2018 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist Current Accepting new patients
Atlanta Rehabilitation and Performance Center CurrentSince Nov 16, 2020 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

2800 Buford Dr
Ste 315
Buford, GA 30519
Phone (678) 450-9933

2920 Ronald Reagan Blvd
Ste 106
Cumming, GA 30041
Phone (770) 887-0502

7378 Friendship Springs Blvd
Ste A
Flowery Branch, GA 30542
Phone (678) 318-8030

1100 Sherwood Park Dr NE
Ste 140
Gainesville, GA 30501
Phone (770) 297-7750

4220 Mundy Mill Pl
Ste 2B
Oakwood, GA 30566
Phone (678) 450-9933

2400 Wisteria Dr
Ste A
Snellville, GA 30078
Phone (770) 982-0102

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 5

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": "1532563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1532563200000",
    "number": "1871070359",
    "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": "374212564",
            "telephone_number": "423-238-7217",
            "fax_number": "423-362-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2295 TOWNE LAKE PKWY STE 148",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301895520",
            "telephone_number": "770-926-2744",
            "fax_number": "770-926-2794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LOUDERMILK",
        "first_name": "PHILLIP",
        "middle_name": "DANIEL",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-26",
        "last_updated": "2018-07-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2018; 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.