NPIMap

Organization Active NPI

PT Solutions of Acworth, LLC

  • Physical Therapist
  • Dallas, GA
National Provider Identifier
1891161352
Registry record updated Jun 24, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PT SOLUTIONS OF ACWORTH, LLC
Practice address
80 Seven Hills Blvd
Suite 105
Dallas, GA 30132-0574
Phone
(678) 402-0515
Fax
(678) 909-0673
NPI assigned
Aug 18, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2016

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

Authorized official

Name
Mr. Dale M Yake, DPT
Title
Ceo
Phone
(678) 403-3560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

80 Seven Hills Blvd
Suite 105
Dallas, GA 30132-0574

Mailing address

PO Box 441146
Kennesaw, GA 30160-9522
Phone (770) 917-1395

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040629000794 GA Part B Supplier - Clinic/Group Practice 0042291817 Receives reassigned benefits from 14 practitioners
33 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Hahira, GA; Watkinsville, GA; Villa Rica, GA; Valdosta, GA; Tyrone, GA; Norcross, GA; Evans, GA; Decatur, GA…

Other NPIs on the same Medicare enrollment 33

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

View all 33

National Provider Directory

National Provider Directory

Locations

80 Seven Hills Blvd
Ste 105
Dallas, GA 30132
Phone (678) 402-0515

Practitioners & affiliated clinicians

Practitioners 10

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1439856000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1466726400000",
    "number": "1891161352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 441146",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301609522",
            "telephone_number": "770-917-1395",
            "fax_number": "770-423-3369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 SEVEN HILLS BLVD",
            "address_2": "SUITE 105",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301320574",
            "telephone_number": "678-402-0515",
            "fax_number": "678-909-0673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PT SOLUTIONS OF ACWORTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-18",
        "last_updated": "2016-06-24",
        "status": "A",
        "authorized_official_last_name": "YAKE",
        "authorized_official_first_name": "DALE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-403-3560",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.