SOAR PHYSICAL THERAPY, INC (NPI# 1083861785) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083861785 |
| Entity Type | Organization |
| Organization Name | SOAR PHYSICAL THERAPY, INC |
| Practice Address |
6884 Hickory Flat Hwy Woodstock GA 30188-3229 |
| Practice Telephone | 7707048244 |
| Practice Fax Number | 7707048264 |
| Mailing Telephone | 7707048244 |
| Mailing Fax Number | 7707048264 |
| Enumeration Date | 2008-08-25 |
| Last Update Date | 2016-03-23 |
| Authorized Official Name | DR. BURTON WILLIAM STEVENS JR. (PHYSICAL THERAPIST/ OWNER) |
| Authorized Official Telephone | 7707048244 |
| Authorized Official Credential | PT, DPT, SCS, AT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
PT009114 | GA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | MEDICARE PTAN | 511G701183 | 01 |
| Street Address |
6884 HICKORY FLAT HWY |
| City | WOODSTOCK |
| State | GA |
| Zip Code | 30188-3229 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093746638 | Burton William Stevens Jr. | Physical Therapist | 6884 Hickory Flat Hwy, Woodstock, GA 30188-3229 | 2006-07-05 |
| 1619502606 | Kathy Rosemary Menard | Massage Therapist | 6884 Hickory Flat Hwy, Woodstock, GA 30188-3229 | 2020-03-10 |
| 1134772510 | Jean Marie Peters | Physical Therapist | 6884 Hickory Flat Hwy, Woodstock, GA 30188-3229 | 2019-07-24 |
| 1629539218 | Nicole Martz Johnson | Massage Therapist | 6884 Hickory Flat Hwy, Woodstock, GA 30188-3229 | 2019-03-27 |
| 1164987889 | Amy Tice | Physical Therapist | 6884 Hickory Flat Hwy, Woodstock, GA 30188-3229 | 2019-02-06 |
| 1619446150 | Mary Gibson Dunn | Massage Therapist | 6884 Hickory Flat Hwy, Woodstock, GA 30188-3229 | 2018-11-14 |
| 1780002451 | Danielle Beatty | Physical Therapist | 6884 Hickory Flat Hwy, Woodstock, GA 30188-3229 | 2014-03-31 |
| 1508088584 | Victoria Lyn Russell | Occupational Therapist | 6884 Hickory Flat Hwy, Woodstock, GA 30188-3229 | 2007-05-02 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1730715814 | Tyler Rose | Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | 116 South Mill Creek Court, Woodstock, GA 30188 | 2020-03-20 |
| 1881224897 | Dr. Tom LLC | Clinic/Center | 5431 Old Highway 5 Ste 206, Holly Springs, GA 30188 | 2020-01-17 |
| 1467090175 | Stacey Robin Hill | Dietitian, Registered | 210 Mcaffee St, Street Address 2, Woodstock, GA 30188 | 2019-12-12 |
| 1326681784 | Margo Vanderveen | Massage Therapist | 605 Old Hickory Road, Woodstock, GA 30188 | 2019-10-17 |
| 1275093437 | Rebekah Ruth Tchouta | Social Worker | 5166 Shotwell St, Woodstock, GA 30188 | 2019-03-23 |
| 1205395829 | Angela M Graves | Behavior Technician | 3229 S Cherokee Ln Ste 1400, Woodstock, GA 30188 | 2019-03-13 |
| 1396233391 | Costco Wholesale Corporation | Hearing Aid Equipment | 113 Lincoln Street, Woodstock, GA 30188 | 2018-04-25 |
| 1659878080 | Alexis K. Brown | Counselor | 3380 Trickum Rd., Bldg 700, Woodstock, GA 30188 | 2018-04-11 |
| 1427555440 | Lisa Marie Anthony | Specialist/Technologist | 400 Arnold Mill Rd, Woodstock, GA 30188 | 2018-04-06 |
| 1497254122 | J.a.h. Enterprises, LLC | Audiologist | 12195 Hwy. 92, Suite 114-325, Woodstock, GA 30188 | 2018-02-08 |
| Find all providers in zip 30188 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841710498 | Georgia Physical Therapy & Sports Medicine Center | Clinic/Center | 970 Woodstock Pkwy Ste 300, Woodstock, GA 30188-4869 | 2017-06-26 |
| 1811511660 | Aria Physical Therapy Services LLC | Clinic/Center | 802 Song Bird Ct, Woodstock, GA 30188-3779 | 2020-06-07 |
| 1841414968 | Gaudio Inc | Clinic/Center | 7914 Highway 92, Ste 100, Woodstock, GA 30189 | 2007-04-12 |
| 1558406397 | Gaudio Inc. Dba Cherokee Physiotherapy | Clinic/Center | 7914 Highway 92, 100, Woodstock, GA 30189-5238 | 2007-02-20 |
| 1356489694 | Majercik Physical Therapy | Clinic/Center | 201 N Throop St, Woodstock, IL 60098-3224 | 2007-02-01 |
| 1487739173 | Rebound Physical Therapy, LLC | Clinic/Center | 1432 Towne Lake Pkwy, 120, Woodstock, GA 30189-8263 | 2006-10-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205159 | Thrive Therapy and Wellness Services LLC | Clinic/Center | 106 Mims Rd, Sylvania, GA 30467-1995 | 2020-11-04 |
| 1851990063 | On The Move Massage & Physical Therapy | Clinic/Center | 7454 Silver Arrow Trl, Austell, GA 30168-2401 | 2020-10-19 |
| 1659979086 | Mvp Physio Dr. | Clinic/Center | 123 Umiya Nagar Cir, Macon, GA 31206-5401 | 2020-10-16 |
| 1972100865 | Resilient Physio, LLC | Clinic/Center | 790 West Ave, Cartersville, GA 30120-3402 | 2020-10-05 |
| 1205441987 | Fortitude Movement & Strength Inc. | Clinic/Center | 5300 Peachtree Rd Unit 2508, Atlanta, GA 30341-2457 | 2020-09-10 |
| 1376151001 | Mother and Baby Wellness Collective, LLC | Clinic/Center | 136 Millstone Way, Canton, GA 30115-7270 | 2020-07-20 |
| 1225646821 | Innovative Therapeutic Solutions, LLC | Clinic/Center | 360 Pharr Rd Ne Apt 404, Atlanta, GA 30305-2391 | 2020-07-20 |
| 1669090544 | Active Body Physiotherapy | Clinic/Center | 2968 Ask Kay Dr Se Ste B, Smyrna, GA 30082-2304 | 2020-07-08 |
| 1487270914 | Docjay Physical Therapy | Clinic/Center | 6740 Shannon Pkwy Ste 14, Union City, GA 30291-2061 | 2020-06-20 |
| 1477176923 | R & J Health Care | Clinic/Center | 6853b Douglas Blvd Ste B, Douglasville, GA 30135 | 2020-05-19 |
| Find all providers with the same taxonomy | ||||
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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.