NPIMap

Organization Active NPI

Emory Physical Therapy, LLC

  • Physical Therapist
  • Dunwoody, GA
National Provider Identifier
1942499652
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
EMORY PHYSICAL THERAPY, LLC
Practice address
2021 Pernoshal CT #2200
Dunwoody, GA 30338
Phone
(404) 778-6031
Fax
(404) 778-6034
NPI assigned
Oct 18, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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 TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

2021 Pernoshal CT #2200
Dunwoody, GA 30338

Mailing address

8259 Wicker Ave
Saint John, IN 46373-8878
Phone (219) 365-6560

Other practice location 1

4555 N Shallowford Rd Ste 112
Dunwoody, GA 30338-6403
Phone (404) 778-6031

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

2021 Pernoshal Ct
#2200
Dunwoody, GA 30338
Phone (404) 778-6031

8259 Wicker Ave
Saint John, IN 46373
Phone (219) 365-6560

NPI Registry JSON

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

{
    "created_epoch": "1192665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1724889600000",
    "number": "1942499652",
    "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": "219-365-6560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 PERNOSHAL CT #2200",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "30338",
            "telephone_number": "404-778-6031",
            "fax_number": "404-778-6034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4555 N Shallowford Rd Ste 112",
            "address_purpose": "LOCATION",
            "city": "Dunwoody",
            "state": "GA",
            "postal_code": "303386403",
            "country_code": "US",
            "telephone_number": "404-778-6031",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "EMORY PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-10-18",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-26",
        "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": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunwoody, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.