SOMATIC PHYSICAL THERAPY LLC (NPI# 1528524352) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528524352 |
| Entity Type | Organization |
| Organization Name | SOMATIC PHYSICAL THERAPY LLC |
| Practice Address |
210 South St Carrollton GA 30117-3738 |
| Mailing Address |
1576 Folkstone Rd Ne Brookhaven GA 30329-1305 |
| Practice Telephone | 4702150862 |
| Mailing Telephone | 9209408350 |
| Mailing Fax Number | 4043934680 |
| Enumeration Date | 2019-02-18 |
| Last Update Date | 2019-02-18 |
| Authorized Official Name | DR. NICHOLAS J LONG (OWNER/PHYSICAL THERAPIST) |
| Authorized Official Telephone | 9209408350 |
| Authorized Official Credential | PT, DPT, CMTPT |
| 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 |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | PT LICENSE NUMBER | PT009781 | 01 |
| GA | DRY NEEDLING CERTIFICATION, MYOPAIN 6-10-18 | 18158 | 01 |
| Other Name | Type Code |
|---|---|
| Somatic Physical Therapy | Former Legal Business Name - Organization |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1576 Folkstone Rd Ne, Brookhaven, GA 303291305 | 9209408350 | 4043934680 |
| Street Address |
210 SOUTH ST |
| City | CARROLLTON |
| State | GA |
| Zip Code | 30117-3738 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306319256 | West Georgia Healthcare | Family Medicine | 210 South St, Carrollton, GA 30117-3738 | 2019-01-03 |
| 1568977015 | Htb Consulting | Chiropractor | 210 South St, Carrollton, GA 30117-3738 | 2017-12-06 |
| 1417148859 | Leigh Alexander Sawyer | Acupuncturist | 210 South St, Carrollton, GA 30117-3738 | 2007-08-08 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679199392 | Southern Rad Onc LLC | Radiology | 809 South Park Street, Carrollton, GA 30117 | 2020-06-18 |
| 1093361404 | Eyedeal Eyecare LLC | Optometrist | 1735 S Us 27, Carrollton, GA 30117 | 2019-08-12 |
| 1710412473 | Janis James | Optometrist | 1735 S, Us-27, Walmart Vision Center, Carrollton, GA 30117 | 2017-05-01 |
| 1568881951 | Omar Hajmurad | Anesthesiology | 812 S Park St Ste 5, Carrollton, GA 30117 | 2014-04-14 |
| 1134550353 | Goodbodys Minor Med Express Care | Nurse Practitioner | 1670 South Park St., Carrollton, GA 30117 | 2013-12-13 |
| 1306187570 | Myriam C Vela-ortiz | Internal Medicine | 157 Clinic Ave Ste 203, Carrollton, GA 30117 | 2013-03-12 |
| 1891030201 | Air Evac Ems, Inc. | Ambulance | 827 Old Bremen Rd, Carrollton, GA 30117 | 2012-12-11 |
| 1952682486 | Angelic Wings Transport, Inc. | Non-emergency Medical Transport (VAN) | 362 B Columbia Drive, Carrollton, GA 30117 | 2011-08-29 |
| 1073819256 | Atlanta Prosthetics & Orthotics, Inc. | Durable Medical Equipment & Medical Supplies | 812 South Park Street, Suite 2, Carrollton, GA 30117 | 2011-02-04 |
| 1255640348 | Amy Gilbert | Counselor | 515 Tanner St, Carrollton, GA 30117 | 2010-10-06 |
| Find all providers in zip 30117 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295125862 | Harmony Physical Therapy, Pllc | Clinic/Center | 2324 Old Denton Rd, 120, Carrollton, TX 75006 | 2015-02-03 |
| 1518126739 | Integrated Athletic Development | Clinic/Center | 2800 N I35, Carrollton, TX 75007-4405 | 2008-06-03 |
| 1730111295 | Occupational Health Centers of The Southwest, P.a. | Clinic/Center | 1345 Valwood Parkway, Suite 306, Carrollton, TX 75006 | 2006-07-07 |
| 1265933709 | Encore Rehabilitation Inc | Clinic/Center | 241 Robert K Wilson Dr, Carrollton, AL 35447-8032 | 2018-02-21 |
| 1356840425 | Surecure LLC | Clinic/Center | 4541 N Josey Ln Ste 130, Carrollton, TX 75010-4662 | 2018-02-05 |
| 1295112308 | Isabel Sanders | Clinic/Center | 241 Robert K Wilson Dr, Pickens County Medical Center, Carrollton, AL 35447 | 2015-04-28 |
| 1154746667 | Backbonz | Clinic/Center | 827 Cedar St, Carrollton, GA 30117-2521 | 2014-02-20 |
| 1538367842 | Affinity Rehabilitation, Inc. | Clinic/Center | 205 Marwill Dr, Riverbourne Medical Plaza, Carrollton, KY 41008-1500 | 2007-07-08 |
| 1609935477 | Terry Rehabilitation & Testing | Clinic/Center | 1428 W Hebron Pkwy, Suite 120, Carrollton, TX 75010-6345 | 2006-12-08 |
| 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 | CARROLLTON |
| Zip Code | 30117 |
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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.