INDEPENDENT PHYSICAL THERAPY OF GA, LLC (NPI# 1043672678) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043672678 |
| Entity Type | Organization |
| Organization Name | INDEPENDENT PHYSICAL THERAPY OF GA, LLC |
| Other Organization Name | BENCHMARK PT - SHALLOWFORD |
| Practice Address |
3855 Shallowford Rd 415 Marietta GA 30062-4195 |
| Mailing Address |
8823 Production Ln Ooltewah TN 37363-6511 |
| Practice Telephone | 6783520828 |
| Enumeration Date | 2016-03-23 |
| Last Update Date | 2016-03-23 |
| Authorized Official Name | KEVIN JOHANESON (VP REVENUE CYCLE) |
| Authorized Official Telephone | 4232383220 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225X00000X | Occupational Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| N | 235Z00000X | Speech-Language Pathologist | Speech, Language and Hearing Service Providers | ||
| Y | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Other Name | Type Code |
|---|---|
| Benchmark PT - Shallowford | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285284505 | Independent Physical Therapy of Ga, LLC | Occupational Therapist | 3630 Thompson Bridge Rd Ste 4, Gainesville, GA 30506-1523 | 2019-09-18 |
| 1588213243 | Independent Physical Therapy of Ga, LLC | Occupational Therapist | 4200 Wade Green Rd Nw Ste 140, Kennesaw, GA 30144-1808 | 2019-09-05 |
| 1578117727 | Independent Physical Therapy of Ga, LLC | Occupational Therapist | 128 Duvall St Ste D, Clayton, GA 30525-5475 | 2019-07-26 |
| 1629636238 | Independent Physical Therapy of Ga, LLC | Occupational Therapist | 2215 Tobacco Rd Ste A, Augusta, GA 30906-8112 | 2019-05-30 |
| 1740742477 | Independent Physical Therapy of Ga, LLC | Occupational Therapist | 1260 Mars Hill Rd Ste 115, Watkinsville, GA 30677-4943 | 2019-04-02 |
| 1962976563 | Independent Physical Therapy of Ga, LLC | Occupational Therapist | 10 Village West Dr. Ste A, Senoia, GA 30276 | 2019-01-16 |
| 1508332537 | Independent Physical Therapy of Ga, LLC | Occupational Therapist | 210 Walmart Way, Eastanollee, GA 30538-3803 | 2018-10-17 |
| 1295242543 | Independent Physical Therapy of Ga, LLC | Occupational Therapist | 885 Dawsonville Hwy Ste 1140, Gainesville, GA 30501-2642 | 2018-01-09 |
| 1417469545 | Independent Physical Therapy of Ga, LLC | Occupational Therapist | 3610 Piedmont Rd Ne Ste 100a, Atlanta, GA 30305-1406 | 2017-10-30 |
| 1982114278 | Independent Physical Therapy of Ga, LLC | Speech-Language Pathologist | 3919 Carter Rd # A, Buford, GA 30518-1628 | 2017-10-02 |
| Street Address |
3855 SHALLOWFORD RD 415 |
| City | MARIETTA |
| State | GA |
| Zip Code | 30062-4195 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407038961 | Hilary Kinzler Delman | Counselor | 3855 Shallowford Rd, Suite 420, Marietta, GA 30062-4195 | 2007-11-27 |
| 1891234670 | Brace Mobility | Durable Medical Equipment & Medical Supplies | 3855 Shallowford Rd, Suite 515, Marietta, GA 30062-4195 | 2017-02-14 |
| 1558760447 | Tyler Gene Miller | Physical Therapist | 3855 Shallowford Rd, Ste 415, Marietta, GA 30062-4195 | 2014-08-18 |
| 1265856025 | Robert Korthoff | Physical Therapist | 3855 Shallowford Rd, Suite 415, Marietta, GA 30062-4195 | 2014-02-13 |
| 1992048136 | Body Core Neuropathy & Spine Group | Chiropractor | 3855 Shallowford Rd, Suite 510, Marietta, GA 30062-4195 | 2013-04-05 |
| 1265770275 | Chj, Inc | Social Worker | 3855 Shallowford Rd, Suite 420, Marietta, GA 30062-4195 | 2013-01-25 |
| 1609193598 | Alicia Ann Crusse | Chiropractor | 3855 Shallowford Rd, Suite 510, Marietta, GA 30062-4197 | 2010-04-30 |
| 1952623290 | Wendy H Deal | Counselor | 3855 Shallowford Rd, Suite 420, Marietta, GA 30062-4195 | 2010-02-26 |
| 1386819035 | Tiffany C Whittington | Counselor | 3855 Shallowford Rd, Suite 420, Marietta, GA 30062-4195 | 2008-04-24 |
| 1336318104 | Laura Anderson Graham | Counselor | 3855 Shallowford Rd, Suite 420, Marietta, GA 30062-4195 | 2008-02-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619578051 | Pamela D Kretzmer | Social Worker | 3855 Shallowford Road, Suite 420, Marietta, GA 30062 | 2020-11-03 |
| 1932714680 | Michelle Chambless | Physical Therapist | Team Rehabilitation Ga01, LLC, 1401 Johnson Ferry Road, Suite 340, Marietta, GA 30062 | 2020-09-10 |
| 1700408887 | Life University | Chiropractor | 1323 Roswell Road, Marietta, GA 30062 | 2020-05-12 |
| 1104451160 | Sno Healthcare Group | Clinic/Center | 2424 Roswell Rd Ste 120, Marietta, GA 30062 | 2020-03-10 |
| 1811536212 | Sandy Plains Dental Group, PC | Dentist | 3460 Sandy Plains Rd, Suite 240, Marietta, GA 30062 | 2020-01-02 |
| 1073159034 | Magdala Tulcie Jodesty-jackson | Social Worker | 4343 Shalloword Road, Building H, Suite 4 Lower Level, Marietta, GA 30062 | 2019-11-25 |
| 1598235178 | Matthew Driggers | Counselor | 4343 Shallowford Rd C2, Marietta, GA 30062 | 2018-11-27 |
| 1750895785 | Emily Grace Minday | Counselor | 4343 Shallowford Road Building C, Suite 1 Lower Level, Marietta, GA 30062 | 2017-11-29 |
| 1477072122 | Jason Lee Amos | Speech-Language Pathologist | 3660 Chestnut Ridge Court, Marietta, GA 30062 | 2017-09-13 |
| 1346761376 | Marian Pomaah Opoku-agyeman | Nurse Practitioner | 4661 Andrea Pointe, Marietta, GA 30062 | 2017-06-29 |
| Find all providers in zip 30062 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932714680 | Michelle Chambless | Physical Therapist | Team Rehabilitation Ga01, LLC, 1401 Johnson Ferry Road, Suite 340, Marietta, GA 30062 | 2020-09-10 |
| 1326658022 | Tim L Ward | Physical Therapist | 1972 Willeo Creek Pt, Marietta, GA 30068-1554 | 2020-08-06 |
| 1104459205 | Lori Reethof | Physical Therapist | 630 Gunby Rd Se, Marietta, GA 30067-5132 | 2020-02-17 |
| 1013563436 | Kristin Lauterbach | Physical Therapist | 3405 Dallas Hwy Sw Ste 601, Marietta, GA 30064-6427 | 2019-08-12 |
| 1285133207 | Ashley Denae Chisholm | Physical Therapist | 3451 Ernest W Barrett Pkwy Nw Ste 170, Marietta, GA 30064-5037 | 2018-02-05 |
| 1356853931 | Samantha Yarc | Physical Therapist | 2850 Johnson Ferry Rd Ste 100, Marietta, GA 30062-5684 | 2017-11-03 |
| 1760901482 | Melissa Centofante | Physical Therapist | 920 Burnt Hickory Rd Nw, Marietta, GA 30064-2041 | 2017-09-13 |
| 1376060509 | Alisa Malte | Physical Therapist | 2285 Priscilla Dr, Marietta, GA 30066-4629 | 2017-08-28 |
| 1861914145 | William Brooks Taylor | Physical Therapist | 335 Roselane St Nw Ste 201, Marietta, GA 30060-7902 | 2017-07-08 |
| 1922537836 | Martin Weatherby | Physical Therapist | 1054 Shallowford Rd, Marietta, GA 30066-1002 | 2017-06-06 |
| Find all providers in MARIETTA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.