Independent Physical Therapy of Ga LLC
NPI 1578064754 · Physical Therapist · Lilburn, GA
Provider details
- NPI number
- 1578064754
- Entity type
- Organization
- Primary specialty
- Physical TherapistRespiratory, Developmental, Rehabilitative and Restorative Service Providers
- Organization subpart
- No
- Authorized official
- Kevin Johanneson, Vp Revenue Cycles(423) 238-2313
Specialties & taxonomies
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Occupational Therapist225X00000X
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
- Speech-Language Pathologist235Z00000X
Speech, Language and Hearing Service Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
8 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2018-02-23
- Last updated
- 2018-02-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.