NPIMap

Organization Active NPI

Emory Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Atlanta, GA
National Provider Identifier
1922018423
Registry record updated Apr 15, 2022
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
21 Ortho LN
Atlanta, GA 30329-2315
Phone
(404) 778-3350
Fax
(404) 778-3185
NPI assigned
Aug 8, 2006
Last updated
Apr 15, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 15, 2022

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

Authorized official

Name
Gregory Cooper
Title
Managing Partner
Phone
(219) 365-6560

Specialties & licenses 1

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

Addresses

Primary practice location

21 Ortho LN
Atlanta, GA 30329-2315

Mailing address

8259 Wicker Ave
Saint John, IN 46373-8878

Other practice location 1

57 Executive Park South NE Ste 190
Atlanta, GA 30329-2248
Phone (404) 778-6390

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
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

Practitioners & affiliated clinicians

Practitioners 352

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.

View all 352

NPI Registry JSON

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1649980800000",
    "number": "1922018423",
    "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"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21 ORTHO LN",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292315",
            "telephone_number": "404-778-3350",
            "fax_number": "404-778-3185"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "57 Executive Park South NE Ste 190",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303292248",
            "country_code": "US",
            "telephone_number": "404-778-6390",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EMORY PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-08",
        "last_updated": "2022-04-15",
        "certification_date": "2022-04-15",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "GREGORY",
        "authorized_official_title_or_position": "MANAGING PARTNER",
        "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 Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 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.