Active NPI
PT Solutions of Acworth, LLC
- Physical Therapist
- Duluth, GA
National Provider Identifier
1922476308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- PT SOLUTIONS OF ACWORTH, LLC
- Practice address
- 3455 Peachtree Industrial Blvd
Suite 825
Duluth, GA 30096-6501 - Phone
- (678) 534-4727
- Fax
- (678) 567-6701
- NPI assigned
- Sep 2, 2015
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
3455 Peachtree Industrial Blvd
Suite 825
Duluth, GA 30096-6501
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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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.
National Provider Directory
National Provider DirectoryLocations
3455 Peachtree Industrial Blvd
Ste 825
Duluth, GA 30096
Phone (678) 534-4727
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1441152000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1466726400000",
"number": "1922476308",
"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": "3455 PEACHTREE INDUSTRIAL BLVD",
"address_2": "SUITE 825",
"city": "DULUTH",
"state": "GA",
"postal_code": "300966501",
"telephone_number": "678-534-4727",
"fax_number": "678-567-6701"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PT SOLUTIONS OF ACWORTH, LLC",
"organizational_subpart": "NO",
"enumeration_date": "2015-09-02",
"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 Duluth, 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.