NPIMap

Organization Active NPI

Sportscare Physical Therapy Inc

  • Physical Therapist
  • Suwanee, GA
National Provider Identifier
1962459883
Registry record updated Oct 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
SPORTSCARE PHYSICAL THERAPY INC
Practice address
4310 Johns Creek Pkwy Ste 130
Suwanee, GA 30024-6092
Phone
(770) 495-0610
Fax
(770) 495-0806
NPI assigned
May 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2023

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

Authorized official

Name
Mrs. Ellen Lewandowski
Title
Cfo
Phone
(770) 713-4363

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X 002277 GA
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X Primary

Addresses

Primary practice location

4310 Johns Creek Pkwy Ste 130
Suwanee, GA 30024-6092

Mailing address

4310 Johns Creek Pkwy Ste 130
Suwanee, GA 30024-6092
Phone (770) 495-0610

Other practice location 1

3655 Howell Ferry Rd Ste 300
Duluth, GA 30096-3186
Phone (678) 878-2192

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20060719000167 GA Part B Supplier - Clinic/Group Practice 3274546197 Receives reassigned benefits from 10 practitioners
Practice locations: Duluth, GA; Suwanee, GA

National Provider Directory

National Provider Directory

Locations

540 Lake Center Pkwy
Ste 107
Cumming, GA 30040
Phone (770) 205-3939

3655 Howell Ferry Rd
Ste 300
Duluth, GA 30096
Phone (678) 541-7270

6920 McGinnis Ferry Rd
Ste 320
Suwanee, GA 30024
Phone (770) 495-0610

4310 Johns Creek Pkwy
Ste 130
Suwanee, GA 30024
Phone (770) 495-0610

Practitioners & affiliated clinicians

Practitioners 35

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 35

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698710400000",
    "number": "1962459883",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4310 JOHNS CREEK PKWY STE 130",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246092",
            "telephone_number": "770-495-0610",
            "fax_number": "770-495-0806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4310 JOHNS CREEK PKWY STE 130",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300246092",
            "telephone_number": "770-495-0610",
            "fax_number": "770-495-0806"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3655 Howell Ferry Rd Ste 300",
            "address_purpose": "LOCATION",
            "city": "Duluth",
            "state": "GA",
            "postal_code": "300963186",
            "country_code": "US",
            "telephone_number": "678-878-2192",
            "fax_number": "678-878-2194",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SPORTSCARE PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A",
        "authorized_official_last_name": "LEWANDOWSKI",
        "authorized_official_first_name": "ELLEN",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "770-713-4363",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "002277",
            "primary": false
        },
        {
            "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 Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.