GEORGIA STATE UNIVERSITY PHYSICAL (NPI# 1477990695) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1477990695 |
| Entity Type | Organization |
| Organization Name | GEORGIA STATE UNIVERSITY PHYSICAL |
| Practice Address |
140 Decatur St Se Atlanta GA 30303-3204 |
| Practice Telephone | 4044131415 |
| Enumeration Date | 2013-05-29 |
| Last Update Date | 2013-05-29 |
| Authorized Official Name | ANDREW BUTLER (OFFICER) |
| Authorized Official Telephone | 4044131415 |
| Authorized Official Credential | PHD, PT |
| 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 |
| Street Address |
140 DECATUR ST SE |
| City | ATLANTA |
| State | GA |
| Zip Code | 30303-3204 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720272966 | Janet Klebek Patton | Psychologist | 140 Decatur St Se, Suite 1056, Atlanta, GA 30303-3204 | 2007-08-30 |
| 1174993299 | Preston Michael Elder | Psychologist | 140 Decatur St Se, Suite 1053, Atlanta, GA 30303-3204 | 2015-10-01 |
| 1548652795 | Molly Larson | Psychologist | 140 Decatur St Se, 1053, Atlanta, GA 30303-3204 | 2015-02-25 |
| 1710143094 | Foluso M Lawal-solarin | Psychologist | 140 Decatur St Se, Suite 750, Atlanta, GA 30303 | 2008-08-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811597461 | Nanoresearch, Inc | Point of Service | 58 Edgewood Ave Ne, Suite 122, Collabtech., Gsu, Atlanta, GA 30303 | 2020-10-31 |
| 1952917155 | Alesha Deshay Elbert | Behavior Technician | 206 Peachstreet Ne Suite 2200, Atlanta, GA 30303 | 2020-09-22 |
| 1033759386 | Mark Bush | Case Manager/Care Coordinator | 50 Hurt Plaza Se Suite 1108, Atlanta, GA 30303 | 2020-01-14 |
| 1053965855 | Patrice Munsel Henry | Nurse Practitioner | 80 Jessie Hill Drive Se, Atlanta, GA 30303 | 2019-07-30 |
| 1356826564 | United States Medical Supply, LLC | Durable Medical Equipment & Medical Supplies | 260 Peachtree Street Nw, Suite 2200, Office 2228, Atlanta, GA 30303 | 2018-10-03 |
| 1336645290 | Joseph Bahng | Student in an Organized Health Care Education/Training Program | 69 Jesse Hill Jr Drive Se, Glenn Building, 4th Floor - 412b, Atlanta, GA 30303 | 2018-03-31 |
| 1841704707 | Amber Peach LLC | Family Medicine | 260 Peachtree St Nw Suite 2200, Atlanta, GA 30303 | 2017-11-29 |
| 1447778089 | Jasmine Williams | Behavioral Analyst | 260 Peachtree Street Nw, Suite 2200, Atlanta, GA 30303 | 2017-09-05 |
| 1982138236 | Mahek Dossani | Behavior Technician | 260 Peachtree Street Nw, Suite 2200, Atlanta, GA 30303 | 2017-04-13 |
| 1255872420 | Alexis Annick Auger | Behavior Technician | 260 Peachtree St. Nw, Suite 2200, Atlanta, GA 30303 | 2017-03-20 |
| Find all providers in zip 30303 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205441987 | Fortitude Movement & Strength Inc. | Clinic/Center | 5300 Peachtree Rd Unit 2508, Atlanta, GA 30341-2457 | 2020-09-10 |
| 1225646821 | Innovative Therapeutic Solutions, LLC | Clinic/Center | 360 Pharr Rd Ne Apt 404, Atlanta, GA 30305-2391 | 2020-07-20 |
| 1700355690 | Lindsay Hazel Bautista | Clinic/Center | 3380 Peachtree Rd Ne Unit 814, Atlanta, GA 30326-1645 | 2018-11-20 |
| 1891281218 | Well Equipt | Clinic/Center | 2426 Ridgewood Rd Nw, Atlanta, GA 30318-1316 | 2018-07-09 |
| 1811426075 | Assistcare Surgical Aftercare and Physical Therapy | Clinic/Center | 3576 Chamblee Tucker Rd Ste Bc&d, Atlanta, GA 30341-4424 | 2017-06-09 |
| 1871022541 | Aczi, LLC | Clinic/Center | 2800 N Druid Hills Rd Ne Ste C, Atlanta, GA 30329-3987 | 2017-06-07 |
| 1134587074 | Functionize Health & Physical Therapy | Clinic/Center | 1199 Saint Andrews Cir, Atlanta, GA 30338-3201 | 2016-02-07 |
| 1952779043 | Holistic Occupational and Physical Therapy | Clinic/Center | 1393 Blairwood Ct, Atlanta, GA 30331-7491 | 2015-09-08 |
| 1225416100 | Fit Core Physical Therapy, Inc. | Clinic/Center | 4779 S Atlanta Rd Se Ste 200, Atlanta, GA 30339-1565 | 2015-05-12 |
| 1538561659 | Golden Way Group Inc | Clinic/Center | 235 Peachtree Street, Suite 400, Atlanta, GA 30303 | 2014-09-19 |
| Find all providers in ATLANTA | ||||
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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.