PHYSICALLY EMPOWERED THERAPY & WELLNESS (NPI# 1114215233) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114215233 |
| Entity Type | Organization |
| Organization Name | PHYSICALLY EMPOWERED THERAPY & WELLNESS |
| Other Organization Name | TRI-CITIES SPORTS MEDICINE AND REHAB |
| Practice Address |
2300 Sugarleaf Trail Hampton GA 30228 |
| Practice Telephone | 7702035144 |
| Mailing Telephone | 7702035144 |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2018-08-01 |
| Authorized Official Name | MR. JEANCARLO ALENCASTRO (CLINIC OWNER) |
| Authorized Official Telephone | 7702035144 |
| Authorized Official Credential | ATC/L |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT001665 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Other Name | Type Code |
|---|---|
| Tri-Cities Sports Medicine and Rehab | Doing Business As Name - Organization |
| Street Address |
2300 SUGARLEAF TRAIL |
| City | HAMPTON |
| State | GA |
| Zip Code | 30228 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679196166 | Mutinta Matimba Hamuwele | Nurse Practitioner | 10988 Genova Ter, Hampton, GA 30228 | 2020-05-19 |
| 1487295044 | Living Testimony Homecare, LLC | Home Health | 10833 Southwood Drive, Hampton, GA 30228 | 2019-10-04 |
| 1598246878 | Emma Ledbetter | Nurse Practitioner | 1910 Elm Park Dr, Hampton, GA 30228 | 2018-08-24 |
| 1720506231 | O'reilly Comprehensive Dermatology, Inc. | Dermatology | 755 Mount Vernon Hwy., Suite 330, Atlanta, GA 30228 | 2017-09-05 |
| 1720500648 | Sophia Demetria Edwards | Home Health Aide | 2059 Grove Way, Hampton, GA 30228 | 2017-07-12 |
| 1083143432 | Ciera Jayna Scales | Dentist | 144 Revolutionary Dr, Hampton, GA 30228 | 2017-06-08 |
| 1811446438 | Alwarna Pasteur | Contractor | 1419 Hyde Court, Hampton, GA 30228 | 2016-09-23 |
| 1932599370 | Corlyn Doolittle | Speech-Language Pathologist | 412 Lakeside Villa Dr, Lovejoy, GA 30228 | 2015-01-23 |
| 1114367596 | Mayer Counseling Services,llc | Counselor | 591 Toronto Circle, Hampton, GA 30228 | 2013-06-28 |
| 1932544269 | Eye Can See Eyewear Inc. | Technician/Technologist | 22 E. Main St. N., Hampton, GA 30228 | 2013-04-30 |
| Find all providers in zip 30228 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609497270 | Jeffrey Wiseman | Specialist/Technologist | 1 Ymca Way Ste B, Hampton, VA 23669-3963 | 2020-05-05 |
| 1558908558 | Sierra Cornog | Specialist/Technologist | 244 Dodgen Rd, Hampton, GA 30228-2007 | 2019-12-09 |
| 1114577798 | Andrew Lunger | Specialist/Technologist | 536 Charlestown Rd, Hampton, NJ 08827-2540 | 2019-09-16 |
| 1851940316 | Brendan S Czarnecki | Specialist/Technologist | 64 Moulton Rd, Hampton, NH 03842-2154 | 2019-09-08 |
| 1396251385 | Nicole L Messamer | Specialist/Technologist | 97 Stapleford Way, Hampton, VA 23669-4966 | 2017-12-28 |
| 1922532100 | Brittany Ford | Specialist/Technologist | 101 Holland Hl, Hampton, VA 23668-0001 | 2017-04-14 |
| 1760831952 | Mikaela Rose Harding | Specialist/Technologist | 1 Alumni Dr, Hampton, NH 03842-2282 | 2016-06-08 |
| 1508227901 | Azalea Alvina Hancock | Specialist/Technologist | 337 Kentwood Springs Dr, Hampton, GA 30228-5941 | 2016-03-11 |
| 1861889917 | Sarah Donovan | Specialist/Technologist | 400 Lafayette Rd, Hampton, NH 03842-2209 | 2015-04-15 |
| 1750359717 | Stephen Cyril Barrett | Specialist/Technologist | 300 Butler Farm Rd, Hampton, VA 23666-1522 | 2006-03-08 |
| Find all providers in HAMPTON | ||||
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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.