Individual provider Active NPI

Nancy Roddy Nurnberg, PT

  • Physical Therapist
  • Saint Simons Island, GA
National Provider Identifier
1992072896
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT000809 Issued in GA
Practice address
20 Market St Ste 102
Saint Simons Island, GA 31522-1986
Phone
(912) 634-5885
NPI assigned
Nov 19, 2011
Sex
Female
Sole proprietor
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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT000809 GA Primary

Addresses

Primary practice location

20 Market St Ste 102
Saint Simons Island, GA 31522-1986

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (866) 518-0283

Other practice location 1

2185 Northlake Pkwy
Suite 100
Tucker, GA 30084-4126
Phone (770) 493-6360

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200910001154 GA Practitioner - Physical Therapist in Private Practice 6709096381 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1972
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independent Physical Therapy of Georgia, LLCGroup PAC ID 2961312244, 526 clinicians

Practice addresses (Care Compare)

1025 E W Connector
Suite 406
Austell, GA 30106-8531
Phone (770) 384-1001

6586 Ga Hwy 40 E
Suite B3
Saint Marys, GA 31558-4041
Phone (912) 809-3015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT000809GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jul 22, 2024 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jul 22, 2024 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Jul 22, 2024 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Jul 22, 2024 Accepting new patients
Functional Pathways Preferred of Tennessee LLC Physical Therapist CurrentSince Aug 10, 2020 Accepting new patients
Atlanta South Physical Therapy, Inc Physical Therapist CurrentSince Jul 22, 2024 Accepting new patients
Benchmark Physical Therapy, Inc CurrentSince Jul 22, 2024 Accepting new patients
Integrated Therapy LLC Physical Therapist CurrentSince Feb 1, 2021 Accepting new patients
All Health Physical Therapy Inc Physical Therapist Past Accepting new patients
Life Clinic of Ga PC Physical Therapist PastSince Dec 3, 2022 Accepting new patients
All Health Physical Therapy Past Accepting new patients

Locations

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

855 North Point Pkwy
Alpharetta, GA 30005
Phone (952) 401-2336

2221 Peachtree Rd NE
Ste D336
Atlanta, GA 30309

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

1823 N Brown Rd
Lawrenceville, GA 30043

20 Market St
Ste 102
St Simons Island, GA 31522
Phone (912) 634-5885

1063 Rockbridge Rd
Stone Mountain, GA 30087

10133 Sherrill Blvd
Ste 200
Knoxville, TN 37932
Phone (865) 392-2847

Organizations & group practices 11

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

NPI Registry JSON

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

{
    "created_epoch": "1321660800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1992072896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "866-518-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 MARKET ST STE 102",
            "city": "SAINT SIMONS ISLAND",
            "state": "GA",
            "postal_code": "315221986",
            "telephone_number": "912-634-5885"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2185 Northlake Pkwy",
            "address_2": "Suite 100",
            "address_purpose": "LOCATION",
            "city": "Tucker",
            "state": "GA",
            "postal_code": "300844126",
            "country_code": "US",
            "telephone_number": "770-493-6360",
            "fax_number": "770-493-6350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "RODDY NURNBERG",
        "first_name": "NANCY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-19",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT000809",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Saint Simons Island, 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.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.