Lauren Bagley, DPT
Individual provider Active NPI Pediatric Physical Therapist · Brookhaven, GA
NPI 1992317168 · NPPES record last updated Aug 19, 2020
Key facts
- NPI
- 1992317168
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Physical Therapist 2251P0200X
- License
- PT014895 (GA)
- Practice address
- 1123 Oxford Cres NE
Brookhaven, GA 30319-1624 - Phone
- (404) 247-7959
- Fax
- (404) 393-2447
- NPI assigned
- Aug 19, 2020
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT014895 | GA | MD | Pediatric Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Therapy Steps Inc | Pediatrics | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist |
2251P0200X | PT014895 | GA | Yes |
Addresses
Primary practice location
1123 Oxford Cres NE
Brookhaven, GA 30319-1624
Mailing address
PO Box 28528
Atlanta, GA 30358-0528
Phone (404) 247-7959
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All providers in Brookhaven, GA · Pediatric Physical Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 19, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.