PEACHTREE WOMEN'S PHYSICAL THERAPY, INC (NPI# 1679728463) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1679728463 |
Entity Type | Organization |
Organization Name | PEACHTREE WOMEN'S PHYSICAL THERAPY, INC |
Practice Address |
110 Bastille Way Suite 100a Fayetteville GA 30214-7620 |
Mailing Address |
105 Englewood Dr Fayetteville GA 30214-3348 |
Practice Telephone | 7704615270 |
Mailing Telephone | 7704615270 |
Enumeration Date | 2008-11-21 |
Last Update Date | 2008-11-21 |
Authorized Official Name | ROBERTA BURNEY (PRESIDENT) |
Authorized Official Telephone | 7704615270 |
Is Organization Subpart | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
1439 | GA | Ambulatory Health Care Facilities |
Street Address |
110 BASTILLE WAY SUITE 100A |
City | FAYETTEVILLE |
State | GA |
Zip Code | 30214-7620 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255419107 | William Charles Arendt Jr. | Dentist | 110 Bastille Way, Fayetteville, GA 30214-7620 | 2006-11-01 |
1508980053 | Roberta Jean Burney | Physical Therapist | 110 Bastille Way, 100, Fayetteville, GA 30214-7620 | 2007-03-19 |
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 | 261QP2000X |
Grouping | Ambulatory Health Care Facilities |
Classification | Clinic/Center |
Specialization | Physical Therapy |
Definition to come... |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255981072 | Delta Healthcare Providers | Clinic/Center | 1275 W Lanier Ave, #200, Fayetteville, GA 30214 | 2019-09-13 |
1578110813 | Encore Rehabilitation, Inc. | Clinic/Center | 1816 Huntsville Hwy, Fayetteville, TN 37334-3787 | 2019-08-21 |
1104319433 | Rise Physical Therapy Pa | Clinic/Center | 3484 W Wedington Dr Ste 4, Fayetteville, AR 72704 | 2018-06-12 |
1710490818 | Marianna Clo Hendrycy | Clinic/Center | 1830 N Crossover Rd, Fayetteville, AR 72701-2725 | 2017-11-10 |
1427218106 | Agape Sports Performance Wellness and Rehab | Clinic/Center | 402 Beckett Lane, Fayetteville, GA 30214 | 2008-06-16 |
1801446711 | Encore Rehabilitation, Inc. | Clinic/Center | 1816 Huntsville Hwy, Fayetteville, TN 37334-3787 | 2019-09-13 |
1245713080 | Held Rehabilitation Services, LLC | Clinic/Center | 500 Lanier Ave W Ste 702, Fayetteville, GA 30214-7643 | 2018-09-07 |
1407343502 | Occupational Health Centers of North Carolina, PC | Clinic/Center | 1702 Owen Dr, Fayetteville, NC 28304-3419 | 2018-04-16 |
1851743009 | Rise Physical Therapy, P.a. | Clinic/Center | 2668 E Citizens Dr Ste 5, Fayetteville, AR 72703 | 2016-07-11 |
1427330737 | Select Physical Therapy | Clinic/Center | 2550 Ravenhill Dr, Fayetteville, NC 28303-9627 | 2011-09-13 |
Find all providers in FAYETTEVILLE |
City | FAYETTEVILLE |
Zip Code | 30214 |
Please comment or provide details below to improve the information on PEACHTREE WOMEN'S PHYSICAL THERAPY, INC.
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.