IDEAL THERAPY, LLC (NPI# 1558508580) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558508580 |
| Entity Type | Organization |
| Organization Name | IDEAL THERAPY, LLC |
| Practice Address |
290 Highway 314 Suite B Fayetteville GA 30214-7813 |
| Mailing Address |
290 Highway 314 Fayetteville GA 30214-7813 |
| Practice Telephone | 4049947727 |
| Practice Fax Number | 4049947728 |
| Mailing Telephone | 4049947727 |
| Mailing Fax Number | 4049947728 |
| Enumeration Date | 2009-01-13 |
| Last Update Date | 2015-02-23 |
| Authorized Official Name | MRS. CORLETTE ALEXIS LUKE-CAMBRIDGE (OWNER) |
| Authorized Official Telephone | 4049947727 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | PT008318 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
290 HIGHWAY 314 SUITE B |
| City | FAYETTEVILLE |
| State | GA |
| Zip Code | 30214-7813 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841269768 | Olistell, Inc. | Home Health | 290 Highway 314, Suite C, Fayetteville, GA 30214-7813 | 2006-03-14 |
| 1154877363 | Krystle Penn | Massage Therapist | 290 Highway 314, Suite B, Fayetteville, GA 30214-7813 | 2016-08-28 |
| 1851740948 | Lakeisha Joseph | Speech-Language Pathologist | 290 Highway 314, Suite B, Fayetteville, GA 30214-7813 | 2016-06-08 |
| 1467808246 | Phedra Fields | Occupational Therapist | 290 Highway 314, Suite B, Fayetteville, GA 30214-7813 | 2016-05-10 |
| 1447623756 | Shamiqua Johnson | Speech-Language Pathologist | 290 Highway 314, Suite B, Fayetteville, GA 30214-7813 | 2015-11-09 |
| 1114205895 | Andrea J Adams | Counselor | 290 Highway 314, Suite D, Fayetteville, GA 30214-7813 | 2011-07-28 |
| 1669750345 | Serenity Counseling & Consulting Services | Counselor | 290 Highway 314, Suite D, Fayetteville, GA 30214-7813 | 2011-07-28 |
| 1013000900 | Laura Marie Carn Smith | Dentist | 290 Highway 314, Suite A, Fayetteville, GA 30214-7813 | 2006-10-02 |
| 1447341359 | Clarence A Parrott | Dentist | 290 Highway 314, Suite A, Fayetteville, GA 30214-7813 | 2006-09-27 |
| 1871698134 | Stacy G Smith | Dentist | 290 Highway 314, Suite A, Fayetteville, GA 30214-7813 | 2006-09-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548872468 | Phyllis Kelly Wood | Nurse Practitioner | 217 Banks Rd, Suite 31, Fayetteville, GA 30214 | 2020-08-21 |
| 1073139317 | Tyisha Salter Scott | Counselor | 110 Habersham Drive, Suite 142, Fayetteville, GA 30214 | 2020-06-23 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1205465895 | Gillian Vaughan Heard | Physician Assistant | 1275 Ga-54 #201, Fayetteville, GA 30214 | 2020-04-06 |
| 1881234557 | Peach Fits,inc | Mastectomy Fitter | 285 Glynn Street South, Suites 102 and 104, Fayetteville, GA 30214 | 2020-01-10 |
| 1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
| 1861965592 | Hierarchy for Wellness | Specialist | 805 S Glynn St Bldg 127 142, Fayetteville, GA 30214 | 2019-01-04 |
| 1356810634 | Fayette Dental Group PC | Clinic/Center | 720 W Lanier Ave, Fayetteville, GA 30214 | 2018-11-16 |
| 1891263299 | Mattie Mae Farmer Clark | Specialist/Technologist, Other | Piedmont Fayette Hospital, 1255 Highway 54 West, Fayetteville, GA 30214 | 2018-11-05 |
| 1093293607 | Allyson Holland | Pharmacist | 880 Highway 85 South, Fayetteville, GA 30214 | 2018-08-06 |
| Find all providers in zip 30214 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821602178 | Ryan Matthew Derby | Physical Therapist | 1191 Fordham Drive, Suite 102, Fayetteville, NC 28304-3774 | 2020-09-03 |
| 1649882705 | P4 Physical Therapy - Fayetteville, LLC | Physical Therapist | 1229 Huntsville Hwy Ste B, Fayetteville, TN 37334-3685 | 2020-08-20 |
| 1295352136 | Jessica Czarnecki | Physical Therapist | 2668 E Citizens Dr Ste 4, Fayetteville, AR 72703-4796 | 2020-06-26 |
| 1194341412 | Camille Franncine Bolton | Physical Therapist | 500 Floy Farr Parkway, Suite 303, Fayetteville, GA 30214 | 2020-06-23 |
| 1245870187 | Patricia Jean Boehlert | Physical Therapist | 4401 Medical Center Dr Ste 401, Fayetteville, NY 13066-6603 | 2020-01-08 |
| 1427691617 | Brandon Merrick | Physical Therapist | 13917 Hickory Trce, Fayetteville, AR 72704-8417 | 2019-10-21 |
| 1841847936 | Abigail Weiskopf | Physical Therapist | 2350 Bentridge Ln Suite 102, Fayetteville, NC 28304-0591 | 2019-08-22 |
| 1932755766 | Jonathan Cole Vaughn | Physical Therapist | 2793 E Millennium Pl Ste 2, Fayetteville, AR 72703-6522 | 2019-08-16 |
| 1205395944 | Sharon Branch | Physical Therapist | 125 Franklin Farms Cir, Fayetteville, GA 30214-3361 | 2019-03-12 |
| 1043796881 | Travis Alexander | Physical Therapist | 3399 Black Forest Dr Ste 3, Fayetteville, AR 72704 | 2018-07-16 |
| Find all providers in FAYETTEVILLE | ||||
| City | FAYETTEVILLE |
| Zip Code | 30214 |
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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.