Active NPI
Prentice Lamar Strawder Jr.
- Physical Therapist
- Columbus, GA
National Provider Identifier
1992386965
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 1479 Grove Park Dr
Columbus, GA 31904-1585 - Phone
- (706) 507-4460
- NPI assigned
- Apr 20, 2021
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
1479 Grove Park Dr
Columbus, GA 31904-1585
Mailing address
1479 Grove Park Dr
Columbus, GA 31904-1585
Phone (706) 507-4460
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210513000497 | GA | Practitioner - Physical Therapist in Private Practice | 2860801321 |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
1335 Stranssner Dr
Brentwood, MO 63144-1872
1650 Lyndon Farm CT
Suite 300
Louisville, KY 40223-4029
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618876800000",
"number": "1992386965",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1479 GROVE PARK DR",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319041585",
"telephone_number": "706-507-4460"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1479 GROVE PARK DR",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319041585",
"telephone_number": "706-507-4460"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STRAWDER",
"first_name": "PRENTICE",
"middle_name": "LAMAR",
"name_suffix": "Jr.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2021-04-20",
"last_updated": "2021-04-20",
"certification_date": "2021-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2021; 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.