DECATUR PHYSICAL THERAPY & SPORTS MEDICINE (NPI# 1962841064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1962841064 |
| Entity Type | Organization |
| Organization Name | DECATUR PHYSICAL THERAPY & SPORTS MEDICINE |
| Practice Address |
487 Winn Way Ste 201 Decatur GA 30030-1728 |
| Practice Telephone | 4042979315 |
| Practice Fax Number | 4042972741 |
| Mailing Telephone | 4042979315 |
| Mailing Fax Number | 4042972741 |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2013-06-21 |
| Authorized Official Name | CECIL M ANDERSON III (SOLE PROPRIETOR) |
| Authorized Official Telephone | 4042979315 |
| Authorized Official Credential | PT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
2841 | GA | Ambulatory Health Care Facilities |
| Street Address |
487 WINN WAY STE 201 |
| City | DECATUR |
| State | GA |
| Zip Code | 30030-1728 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801413174 | Pa-c Surgical Assist, LLC | Clinic/Center | 520 W Ponce Leon Ave #1706, Decatur, GA 30030 | 2020-07-02 |
| 1417587478 | Elizabeth Heffron | Acupuncturist | 619b East College Avenue, Decatur, GA 30030 | 2020-01-17 |
| 1669016143 | Atlanta Upper Cervical Chiropractic LLC | Chiropractor | 125 E Trinity Place, Suite #247, Decatur, GA 30030 | 2019-10-29 |
| 1831757418 | Jessica Stewart | Counselor | 755 Commerce Dr Ste 903, Decatur, GA 30030 | 2019-05-30 |
| 1699238733 | Dinah Augustin | Registered Nurse | 1458 Church St., Unit B, Decatur, GA 30030 | 2019-04-06 |
| 1093284291 | Eliza Segell | Social Worker | 165 Dekalb Industrial Way Ste D-1, Decatur, GA 30030 | 2018-11-16 |
| 1912476466 | Positive Impact Health Centers, Inc. | Pharmacy | 523 Church Street, Suite B, Decatur, GA 30030 | 2018-11-14 |
| 1932685096 | T2 Imaging | Radiology | 1376 Church Street, Suite 100, Decatur, GA 30030 | 2018-07-12 |
| 1992292858 | Keeanna M Powell | Counselor | Agape Transformation Practice, 235 E. Ponce De Leon Ave Suite 103, Decatur, GA 30030 | 2018-04-17 |
| 1780185488 | Solutions Ae Inc | Counselor | One West Square Court, Suite 710, Decatur, GA 30030 | 2018-02-27 |
| Find all providers in zip 30030 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619456019 | Atlanta Physical Therapy | Clinic/Center | 338 Hillcrest Ave Apt E, Decatur, GA 30030-2068 | 2018-08-07 |
| 1588115984 | Encore Rehab of Priceville | Clinic/Center | 1794 S Bethel Rd, Suite C, Decatur, AL 35603-5410 | 2016-10-20 |
| 1730635087 | Elite Physical Therapy and Wellness, Inc. | Clinic/Center | 135 7th St, Decatur, MS 39327 | 2016-08-28 |
| 1427451244 | Michael Henry Jr. | Clinic/Center | 4153 Flat Shoals Pkwy Building C, Suite 300 A, Decatur, GA 30034-4106 | 2014-10-07 |
| 1437492725 | Agilitas Usa Inc | Clinic/Center | 1241 Pt Mallard Pkwy Ste 201, Decatur, AL 35601-6555 | 2013-04-04 |
| 1295922193 | Stay Strong Solution, LLC | Clinic/Center | 117 Running Bear Trail, Decatur, TX 76234 | 2007-09-25 |
| 1558583708 | Active Physical Therapy, Inc. | Clinic/Center | 2424 Danville Rd. Sw, Ste M, Decatur, AL 35603 | 2007-05-03 |
| 1003819608 | Encore Rehabilitation, Inc | Clinic/Center | 251 Johnston St, Suite 300, Decatur, AL 35601-2515 | 2005-05-27 |
| 1871032243 | Peak Physical Therapy and Wellness | Clinic/Center | 216 Johnston St Se, Decatur, AL 35601-2516 | 2017-02-18 |
| 1750826475 | Carinity Therapy Services LLC | Clinic/Center | 1629 4th Ave Se, Suite 120 D, Decatur, AL 35601-4900 | 2017-01-04 |
| Find all providers in DECATUR | ||||
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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.