Individual provider Active NPI

Samuel Ross Hall, P.T.

  • Orthopedic Physical Therapist
  • Woodstock, GA
National Provider Identifier
1972766640
Registry record updated Nov 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT009344 Issued in GA
Practice address
2230 Towne Lake Pkwy
BLDG 1200, Suites 100 & 110
Woodstock, GA 30189-5540
Phone
(770) 926-2744
Fax
(770) 926-2794
NPI assigned
Jul 3, 2008
Last updated
Nov 18, 2010By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT009344 GA Primary

Addresses

Primary practice location

2230 Towne Lake Pkwy
BLDG 1200, Suites 100 & 110
Woodstock, GA 30189-5540

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100825000357 GA Practitioner - Physical Therapist in Private Practice 5597889717 Reassigns benefits to 3 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT009344GAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy, Inc CurrentSince Jan 1, 2014 Accepting new patients
Independent Physical Therapy of Georgia, LLC Orthopedic CurrentSince Mar 29, 2010 Accepting new patients
Benchmark Physical Therapy Inc CurrentSince Jan 1, 2014 Accepting new patients
Agilitas USA, Inc Orthopedic CurrentSince May 29, 2023 Accepting new patients
Independent Physical Therapy of Georgia, LLC Current Accepting new patients
Independent Physical Therapy of Ga, LLC CurrentSince Mar 29, 2010 Accepting new patients
Agilitas USA Inc Orthopedic CurrentSince May 29, 2023 Accepting new patients
Independent Physical Therapy of Georgia, LLC Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

12850 Highway 9 N
Ste 1050
Alpharetta, GA 30004
Phone (678) 332-5800

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

11490 Alpharetta Hwy
Ste 200
Roswell, GA 30076
Phone (770) 740-8592

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

8823 Production Ln
Ooltewah, TN 37363
Phone (423) 238-8923

Organizations & group practices 8

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1215043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1290038400000",
    "number": "1972766640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2230 TOWNE LAKE PKWY",
            "address_2": "BLDG 1200, SUITES 100 & 110",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301895540",
            "telephone_number": "770-926-2744",
            "fax_number": "770-926-2794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALL",
        "first_name": "SAMUEL",
        "middle_name": "ROSS",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-07-03",
        "last_updated": "2010-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "GA",
            "license": "PT009344",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Nov 18, 2010; 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.