CLUB PT, LLC (NPI# 1255990123) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1255990123 |
| Entity Type | Organization |
| Organization Name | CLUB PT, LLC |
| Practice Address |
53 W Brookhaven Dr Ne Brookhaven GA 30319-1101 |
| Mailing Address |
2347 Brookhurst Dr Dunwoody GA 30338-6631 |
| Practice Telephone | 7062551150 |
| Mailing Telephone | 7062551150 |
| Enumeration Date | 2019-06-13 |
| Last Update Date | 2019-06-13 |
| Authorized Official Name | DR. RHETT ANTHONY ROBERSON (OWNER/PRESIDENT) |
| Authorized Official Telephone | 7062551150 |
| Authorized Official Credential | PT, DPT, OCS,FAA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Club Physical Therapy | Doing Business As Name - Organization |
| Street Address |
53 W BROOKHAVEN DR NE |
| City | BROOKHAVEN |
| State | GA |
| Zip Code | 30319-1101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215556717 | Ronika Cotton | Marriage & Family Therapist | 2002 Summit Boulevard, Suite 300, Atlanta, GA 30319 | 2020-04-14 |
| 1093369548 | Gordon Peace | Physical Therapist | 705 Town Blvd Ne S 550, Atlanta, GA 30319 | 2019-08-01 |
| 1124682281 | Tiffany Nicole Blamble | Physician Assistant | 2235 Briarwood Way Ne, Brookhaven, GA 30319 | 2019-04-24 |
| 1891286860 | Sandy Springs Center for Urologic Surgery LLC | Clinic/Center | 1450 S Johnson Ferry Rd Ste 100, Atlanta, GA 30319 | 2018-05-24 |
| 1578070355 | Aaron Knott | Physical Therapist | 4260 Peachtree Road, Atlanta, GA 30319 | 2018-01-03 |
| 1639683832 | Lauren Hamann | Physical Therapist | 3777 Peachtree Rd Ne Apt 933, Brookhaven, GA 30319 | 2017-11-27 |
| 1760993984 | Caroline M. Brackette | Counselor | 2002 Summit Blvd Ste 300, Brookhaven, GA 30319 | 2017-10-15 |
| 1700328713 | Christina Head | Counselor | 1350 Dresden Drive, Atlanta, GA 30319 | 2016-11-08 |
| 1528432572 | Hillary Allyn Olivier | Occupational Therapist | 3747 Peachtree Rd, Atlanta, GA 30319 | 2015-11-13 |
| 1285025304 | Karl Weismantel | Physical Therapy Assistant | 1000 Lenox Park Blvd, Atlanta, GA 30319 | 2015-02-11 |
| Find all providers in zip 30319 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750880803 | Emory Physical Therapy, LLC | Clinic/Center | 1968 Hawks Lane, Brookhaven, GA 30329-2283 | 2018-02-05 |
| 1669908786 | Movement Matters LLC | Clinic/Center | 2274 Matthews St Ne, Brookhaven, GA 30319-3809 | 2017-05-10 |
| 1275151060 | Kaleigh Morgan Freel | Clinic/Center | 3535 Ashton Woods Dr Ne, Brookhaven, GA 30319-2201 | 2020-07-08 |
| 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 | ||||
| City | BROOKHAVEN |
| Zip Code | 30319 |
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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.