NPIMap

Organization Active NPI

PT Solutions of Acworth, LLC

  • Physical Therapist
  • Woodstock, GA
National Provider Identifier
1972659332
Registry record updated Feb 9, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
PT SOLUTIONS OF ACWORTH, LLC
Practice address
1816 Eagle Dr
Building 100, Suite C
Woodstock, GA 30189-8272
Phone
(770) 516-9191
Fax
(678) 802-7377
NPI assigned
Jan 26, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 9, 2016

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

Authorized official

Name
Mr. Dale Yake, DPT
Title
Ceo
Phone
(678) 403-3560

Specialties & licenses 1

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

Addresses

Primary practice location

1816 Eagle Dr
Building 100, Suite C
Woodstock, GA 30189-8272

Mailing address

PO Box 242278
Montgomery, AL 36124-2278
Phone (334) 625-5795

Other names 1

  • Woodstock Physical Therapy and Performance Institute, LLC Former legal business name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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.

View all 33

National Provider Directory

National Provider Directory

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

1100 Circle 75 Pkwy SE
Ste 1400
Atlanta, GA 30339
Phone (678) 403-3555

200 Parkbrooke Dr
Woodstock, GA 30189
Phone (678) 888-0500

1816 Eagle Dr
Bldg 100
Woodstock, GA 30189
Phone (770) 516-9191

Practitioners & affiliated clinicians

Practitioners 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1454976000000",
    "number": "1972659332",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 242278",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361242278",
            "telephone_number": "334-625-5795",
            "fax_number": "334-396-4905"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1816 EAGLE DR",
            "address_2": "BUILDING 100, SUITE C",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301898272",
            "telephone_number": "770-516-9191",
            "fax_number": "678-802-7377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PT SOLUTIONS OF ACWORTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2016-02-09",
        "status": "A",
        "authorized_official_last_name": "YAKE",
        "authorized_official_first_name": "DALE",
        "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 SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Woodstock Physical Therapy and Performance Institute, LLC",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 9, 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.

Verify at the official NPI Registry.