NPIMap

Organization Active NPI

Fyz 400 LLC

Doing business as Fyzical Therapy and Balance Centers

  • Physical Therapy Clinic/Center
  • Cumming, GA
National Provider Identifier
1912622960
Registry record updated Oct 11, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
FYZ 400 LLC
Doing business as
Fyzical Therapy and Balance Centers
Practice address
1605 Buford Hwy Ste B
Cumming, GA 30041-6586
Phone
(470) 680-0960
NPI assigned
Oct 11, 2022
Last updated
Oct 11, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2022

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

Authorized official

Name
Douglas James Taylor
Title
Owner
Phone
(470) 680-0960

Specialties & licenses 1

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

Addresses

Primary practice location

1605 Buford Hwy Ste B
Cumming, GA 30041-6586

Mailing address

2211 Glenridge LN
Cumming, GA 30041-0201
Phone (678) 595-7532

Other names 1

  • Fyzical Therapy and Balance Centers Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20221118001663 GA Part B Supplier - Clinic/Group Practice 0547638736 Receives reassigned benefits from 4 practitioners
Practice locations: Cumming, GA

National Provider Directory

National Provider Directory

Locations

1605 Buford Hwy
Ste B
Cumming, GA 30041
Phone (470) 560-3123

Practitioners & affiliated clinicians

Practitioners 6

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": "1665446400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665446400000",
    "number": "1912622960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2211 GLENRIDGE LN",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300410201",
            "telephone_number": "678-595-7532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 BUFORD HWY STE B",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300416586",
            "telephone_number": "470-680-0960"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FYZ 400 LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-11",
        "last_updated": "2022-10-11",
        "certification_date": "2022-10-11",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "DOUGLAS",
        "authorized_official_middle_name": "JAMES",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "470-680-0960"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Fyzical Therapy and Balance Centers",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2022; 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.