INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC (NPI# 1558622217) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558622217 |
| Entity Type | Organization |
| Organization Name | INDEPENDENT PHYSICAL THERAPY OF GEORGIA, LLC |
| Other Organization Name | BENCHMARK |
| Practice Address |
4600 W Village Pl Se Ste 4007 Smyrna GA 30080-9213 |
| Mailing Address |
8823 Production Ln Ooltewah TN 37363-6511 |
| Practice Telephone | 7704382015 |
| Practice Fax Number | 7704388536 |
| Mailing Telephone | 4232387217 |
| Mailing Fax Number | 4232383473 |
| Enumeration Date | 2012-05-30 |
| Last Update Date | 2012-06-05 |
| Authorized Official Name | KILEY RUSSELL (MANAGER) |
| Authorized Official Telephone | 4232388923 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
| N | 261QX0100X |
Clinic/Center Specialization: Occupational Medicine |
Ambulatory Health Care Facilities | ||
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| BenchMark | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518418409 | Independent Physical Therapy of Georgia, LLC | Occupational Therapist | 330 Turner Mccall Blvd Sw Ste 2000, Rome, GA 30165-5618 | 2016-10-17 |
| 1114384500 | Independent Physical Therapy of Georgia, LLC | Occupational Therapist | 744 Noah Dr Ste 107, Jasper, GA 30143-8704 | 2016-01-15 |
| 1497159198 | Independent Physical Therapy of Georgia, LLC | Occupational Therapist | 1021 Parkway Blvd, Ste 101, Athens, GA 30606-6189 | 2014-10-09 |
| 1376956003 | Independent Physical Therapy of Georgia, LLC | Clinic/Center | 5500 Chamblee Dunwoody Rd Ste 5b, Dunwoody, GA 30338-4162 | 2014-06-10 |
| 1437589116 | Independent Physical Therapy of Georgia, LLC | Occupational Therapist | 463 Turner Mccall Blvd Ne, Rome, GA 30165-2735 | 2013-11-18 |
| 1225462740 | Independent Physical Therapy of Georgia, LLC | Clinic/Center | 2120 W Spring St Ste 1600, Monroe, GA 30655-3901 | 2013-09-03 |
| 1366883746 | Independent Physical Therapy of Georgia, LLC | Clinic/Center | 3455 Peachtree Pkwy Ste 206, Suwanee, GA 30024-9104 | 2013-07-12 |
| 1770837445 | Independent Physical Therapy of Georgia, LLC | Clinic/Center | 3885 Princeton Lakes Way Sw Ste 408, Atlanta, GA 30331-5599 | 2012-11-02 |
| 1457608861 | Independent Physical Therapy of Georgia, LLC | Occupational Therapist | 1453 Riverstone Pkwy, Ste 170, Canton, GA 30114-5626 | 2012-08-06 |
| 1780947978 | Independent Physical Therapy of Georgia, LLC | Clinic/Center | 2255 Peachtree Rd Ne, Ste G, Atlanta, GA 30309-1101 | 2012-06-21 |
| Street Address |
4600 W VILLAGE PL SE STE 4007 |
| City | SMYRNA |
| State | GA |
| Zip Code | 30080-9213 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386790947 | Yen Lien Tran | Physical Therapist | 4600 W Village Pl Se Ste 4007, Smyrna, GA 30080-9213 | 2007-01-26 |
| 1043817893 | Allison Marie O'halloran | Physical Therapist | 4600 W Village Pl Se Ste 4007, Smyrna, GA 30080-9213 | 2020-10-05 |
| 1073125910 | Alyssa Marie Martinek | Physical Therapist | 4600 W Village Pl Se Ste 4007, Smyrna, GA 30080-9213 | 2020-08-21 |
| 1881228948 | Mary Ngoctran Nguyen | Physical Therapist | 4600 W Village Pl Se Ste 4007, Smyrna, GA 30080-9213 | 2020-02-27 |
| 1831750934 | Anuradhika Ishara Lepoth Deniyage | Physical Therapist | 4600 W Village Pl Se Ste 4007, Smyrna, GA 30080-9213 | 2019-06-28 |
| 1568953685 | Mishal Mirzali Lakhani | Physical Therapist | 4600 W Village Pl Se Ste 4007, Smyrna, GA 30080 | 2018-05-24 |
| 1780108894 | Jenny Liana Wagner | Physical Therapist | 4600 W Village Pl Se Ste 4007, Smyrna, GA 30080-9213 | 2017-07-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881205169 | Suny Varughese | Nurse Practitioner | Minute Clinic, 2994 Atlanta Rd, Se, Smyrna, GA 30080 | 2020-08-11 |
| 1891287645 | Provident Group - Creekside Properties LLC | Alzheimer Center (Dementia Center) | 4838 South Cobb Drive, Smyrna, GA 30080 | 2018-06-06 |
| 1710490743 | Alina Rim | Registered Nurse | 4532 Chelton Ct Se, Smyrna, GA 30080 | 2017-11-13 |
| 1932626488 | Richard Kyle Davis | Pharmacist | 2955 Atlanta Rd Se, Smyrna, GA 30080 | 2017-08-25 |
| 1982071163 | Amelia Rafaela Turrubiates-huacuja | Counselor | 1246-c Concord Rd, Suite 101, Smyrna, GA 30080 | 2015-08-24 |
| 1275919755 | Anne Waldner Rohling | Physical Therapist | 1155 Concord Rd Se Ste 210, Smyrna, GA 30080 | 2015-08-06 |
| 1790167856 | Kay Yetunde Johnson | Nurse Practitioner | 3001 Lusk Dr, Smyrna, GA 30080 | 2015-06-25 |
| 1689055436 | Anew You Couneling, LLC | Community/Behavioral Health | 3188 Atlanta Rd, Smyrna, GA 30080 | 2015-06-17 |
| 1457766370 | Trondi Jerry | Counselor | 3381 Atlanta Rd Se, Smyrna, GA 30080 | 2014-06-30 |
| 1093081903 | Ashish Kapila | Podiatrist | Wellstar Podiatry, 4441 Atlanta Rd Se Suite 215, Smyrna, GA 30080 | 2012-03-25 |
| Find all providers in zip 30080 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669090544 | Active Body Physiotherapy | Clinic/Center | 2968 Ask Kay Dr Se Ste B, Smyrna, GA 30082-2304 | 2020-07-08 |
| 1528582145 | Emory Physical Therapy, LLC | Clinic/Center | 3903 S Cobb Dr Se Ste 275, Smyrna, GA 30080-8504 | 2017-07-26 |
| 1609272327 | Hold Fast | Clinic/Center | 3600 Highlands Pkwy Se, Building 4 Lower Floor, Smyrna, GA 30082-5184 | 2014-11-06 |
| 1568495646 | Physiotherapy Associates Inc | Clinic/Center | 739 President Pl, Suite 200, Smyrna, TN 37167-6844 | 2006-07-09 |
| 1841815354 | Smyrna Hand Therapy, LLC | Clinic/Center | 1290 W Spring St Se Ste 130, Smyrna, GA 30080-3689 | 2020-06-10 |
| 1942853379 | Agilitas Usa, Inc | Clinic/Center | 1155 Concord Rd Se Ste 210, Smyrna, GA 30080-4234 | 2019-07-24 |
| 1720458557 | Full Circle Therapy, Pllc | Clinic/Center | 215 Wellington Way, Smyrna, TN 37167-5739 | 2015-10-06 |
| 1518364231 | Hold Fast Motion | Clinic/Center | 3600 Highlands Pkwy Se, Building 4 Lower Floor, Smyrna, GA 30082-5184 | 2014-11-24 |
| 1538494828 | Set Sports Physical Therapy | Clinic/Center | 1800 Lake Park Dr Se Ste 101, Smyrna, GA 30080-7639 | 2009-10-05 |
| 1386798031 | Agilitas Usa Inc. | Clinic/Center | 741 President Pl Ste 130, Smyrna, TN 37167-6808 | 2007-01-22 |
| Find all providers in SMYRNA | ||||
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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.