Decatur Physical Therapy & Sports Medicine

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

2841 Issued in GA

Legal business name

DECATUR PHYSICAL THERAPY & SPORTS MEDICINE

Practice address

487 Winn Way Ste 201
Decatur, GA 30030-1728

Phone

(404) 297-9315

Fax

(404) 297-2741

NPI assigned

Jun 21, 2013

Organization subpart

No

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

Authorized official

Name

Cecil M Anderson III, PTNPI 1568412369

Title

Sole Proprietor

Phone

(404) 297-9315

Specialties & licenses 1

Addresses

Locations

Practitioners 2

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

• Cecil M. Anderson III, P.T.

  • Physical Therapist
  • Decatur, GA
  • NPI 1568412369
  NPD (past) Authorized official
• Charles L Owen Jr., PT, DPT, OCS, CSCS

  • Physical Therapist
  • Decatur, GA
  • NPI 1124304829
  NPD (past)

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

{
    "created_epoch": "1371772800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1371772800000",
    "number": "1962841064",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "487 WINN WAY STE 201",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301728",
            "telephone_number": "404-297-9315",
            "fax_number": "404-297-2741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "487 WINN WAY STE 201",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301728",
            "telephone_number": "404-297-9315",
            "fax_number": "404-297-2741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DECATUR PHYSICAL THERAPY & SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-06-21",
        "last_updated": "2013-06-21",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "CECIL",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SOLE PROPRIETOR",
        "authorized_official_telephone_number": "404-297-9315",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "GA",
            "license": "2841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Decatur Health Resources, Inc.
• Decatur Medical Supplies
• Decatur Mindfulness and Psychotherapy LLC
• Decatur Ortho-Neuro Group LLC
• Decatur Pain & Rehab
• Decatur Psychology, LLC
• Decatur Recovery Services, Inc.
• Decatur Rehab Center, LLC
• Decatur Spine & Joint Center, LLC
• Decatur Urology Surgery Center

• Physical Therapy Clinic/Center in Decatur, GA
• Providers in Decatur, GA by specialty
• Physical Therapy Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.