NPIMap

Organization Active NPI

Emory Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Lagrange, GA
National Provider Identifier
1891513701
Registry record updated Sep 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
EMORY PHYSICAL THERAPY, LLC
Practice address
1801 Vernon Rd
Lagrange, GA 30240-4041
Phone
(800) 341-1703
Fax
(877) 716-4609
NPI assigned
Sep 30, 2024
Last updated
Sep 30, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 30, 2024

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

Authorized official

Name
Gregory L Cooper
Title
Auth Official/Managing Employee
Phone
(219) 365-6560

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

1801 Vernon Rd
Lagrange, GA 30240-4041

Mailing address

8259 Wicker Ave
Saint John, IN 46373-8878
Phone (800) 341-1703

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20041019000776 GA Part B Supplier - Clinic/Group Practice 1153382676 Receives reassigned benefits from 310 practitioners
14 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Jonesboro, GA; Tucker, GA; Smyrna, GA; Lithonia, GA; Lagrange, GA; Johns Creek, GA; Flowery Branch, GA; Dunwoody, GA…

Other NPIs on the same Medicare enrollment 14

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

View all 14

National Provider Directory

National Provider Directory
Tax ID family
Emory Physical Therapy LLC14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

Locations

1801 Vernon Rd
Lagrange, GA 30240
Phone (706) 845-9383

Practitioners & affiliated clinicians

Practitioners 1

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": "1727654400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1727654400000",
    "number": "1891513701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8259 WICKER AVE",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463738878",
            "telephone_number": "800-341-1703",
            "fax_number": "877-719-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 VERNON RD",
            "city": "LAGRANGE",
            "state": "GA",
            "postal_code": "302404041",
            "telephone_number": "800-341-1703",
            "fax_number": "877-716-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EMORY PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-09-30",
        "last_updated": "2024-09-30",
        "certification_date": "2024-09-30",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "AUTH OFFICIAL/MANAGING EMPLOYEE",
        "authorized_official_telephone_number": "219-365-6560"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lagrange, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2024; 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.