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

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
PT014895GAMDPediatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Therapy Steps Inc Pediatrics Past
since Aug 23, 2020
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Physical Therapist
Group: 193400000X SINGLE SPECIALTY GROUP
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

Other providers in Brookhaven, GA

All providers in Brookhaven, GA · Pediatric Physical Therapist in Georgia

Sources for this page

Verify at the official NPI Registry.