Spine & Sport Physical Therapy LP

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SPINE & SPORT PHYSICAL THERAPY LP

Practice address

3895 Cherokee St NW
Suite 612
Kennesaw, GA 30144-6727

Phone

(770) 422-3777

Fax

(770) 422-7799

NPI assigned

Sep 15, 2006

Organization subpart

No

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

Authorized official

Name

Jaanna P. King, JD

Title

VP/Authorized Official

Phone

(713) 297-7000

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1881790988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 W SAM HOUSTON PKWY S",
            "address_2": "SUITE 300",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770422447",
            "telephone_number": "713-297-7000",
            "fax_number": "713-297-7090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3895 CHEROKEE ST NW",
            "address_2": "SUITE 612",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301446727",
            "telephone_number": "770-422-3777",
            "fax_number": "770-422-7799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINE & SPORT PHYSICAL THERAPY LP",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "JAANNA",
        "authorized_official_middle_name": "P.",
        "authorized_official_title_or_position": "VP/AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "713-297-7000",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.