GEORGIA TECH SPORTS MEDICINE AND REHAB
NPI 1417178633
Physical Therapist in Atlanta, GA

NPI Status: Active since May 02, 2007

Contact Information

150 BOBBY DODD WAY
ATLANTA, GA
ZIP 30332
Phone: (404) 385-4115
Fax: (404) 894-0695

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  • Organization
  • Physical Therapist
  • CLIA Number: 11D0671719
  • CLIA Cert. Type: School/Student Health Service
  • CLIA Exp. Date: 09-17-2026

About GEORGIA TECH SPORTS MEDICINE AND REHAB

This page provides the complete NPI Profile along with additional information for Georgia Tech Sports Medicine And Rehab, a provider established in Atlanta, Georgia operating as a Physical Therapist. The healthcare provider is registered in the NPI registry with number 1417178633 assigned on May 2007. The practitioner's primary taxonomy code is 225100000X with license number 6601 (GA). The provider is registered as an organization and their NPI record was last updated 6 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Mr. Charlie Ridgeway Bs, Pt (Physical Therapist Clinic Director)

NPI
1417178633
Provider Name
GEORGIA TECH SPORTS MEDICINE AND REHAB
Entity Type
Organization
Location Address
150 BOBBY DODD WAY ATLANTA, GA 30332
Location Phone
(404) 385-4115
Location Fax
(404) 894-0695
Mailing Address
150 BOBBY DODD WAY ATLANTA, GA 30332
Mailing Phone
(404) 385-4115
Mailing Fax
(404) 894-0695
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
05-02-2007
Last Update Date
08-22-2020
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Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Physical Therapist

Taxonomy Code
225100000X
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
License No.
6601
License State
GA
Taxonomy Description
Physical therapists (PTs) are licensed health care professionals who diagnose and treat individuals of all ages, from newborns to the very oldest, who have medical problems or other health-related conditions that limit their abilities to move and perform functional activities in their daily lives. PTs examine each individual and develop a plan using treatment techniques to promote the ability to move, reduce pain, restore function, and prevent disability. In addition, PTs work with individuals to prevent the loss of mobility before it occurs by developing fitness- and wellness-oriented programs for healthier and more active lifestyles. PTs:
  • Diagnose and manage movement dysfunction and enhance physical and functional abilities.
  • Restore, maintain, and promote not only optimal physical function but optimal wellness and fitness and optimal quality of life as it relates to movement and health.
  • Prevent the onset, symptoms, and progression of impairments, functional limitations, and disabilities that may result from diseases, disorders, conditions, or injuries.
  • Treat conditions of the musculoskeletal, neuromuscular, cardiovascular, pulmonary, and/or integumentary systems.
  • Address the negative effects attributable to unique personal and environmental factors as they relate to human performance.
PTs provide care for people in a variety of settings, including hospitals, private practices, outpatient clinics, home health agencies, schools, sports and fitness facilities, work settings, and nursing homes. State licensure is required in each state in which a PT practices.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

MR. CHARLIE RIDGEWAY BS, PT

Authorized Official Title
PHYSICAL THERAPIST CLINIC DIRECTOR
Authorized Official Phone
(404) 385-4115

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
11D0671719
Facility Type
School/Student Health Service
Certificate Effective Date
September 18, 2024
Certificate Expiration Date
September 17, 2026
Laboratory Director
DR. JANETTA BRYKSIN
Certificate Type
Certificate of Accreditation
Certificate Type Description
This is a CLIA certificate is issued to Georgia Tech Sports Medicine And Rehab on the basis of the laboratory's accreditation by an accreditation organization approved by CMS. This type of certificate is issued to a laboratories tha perform nonwaived (moderate and/or high complexity) testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1417178633, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 67. The final step is to find the difference between that total and the next multiple of ten (70 - 67 = 3).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
4
Unchanged
Pos 3
1
Doubled → 2
Pos 4
7
Unchanged
Pos 5
1
Doubled → 2
Pos 6
7
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
6
Unchanged
Pos 9
3
Doubled → 6
Check
3
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 1 → 2 8 → 16 → 7 3 → 6

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 4 + 2 + 7 + 2 + 7 + 1 + 6 + 6 + 6 + 24 = 67

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 67 is 70. The difference is the calculated check digit.

70 - 67 = 3
This NPI is valid
The calculated check digit is 3, which matches the last digit of 1417178633.

Other Providers at the Same Location


The following 4 providers are registered at the same or a nearby location.

Chiropractor
150 BOBBY DODD WAY
ATLANTA, GA 30332
Specialist/Technologist (Athletic Trainer)
150 BOBBY DODD WAY, GTAA
ATLANTA, GA 30332
Physical Therapist
150 BOBBY DODD WAY
ATLANTA, GA 30332
Specialist/Technologist (Athletic Trainer)
150 BOBBY DODD WAY
ATLANTA, GA 30332

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1417178633, enumerated as an "organization" on May 02, 2007.

The provider is located at 150 BOBBY DODD WAY ATLANTA, GA 30332 and the phone number is (404) 385-4115.

Physical Therapist with taxonomy code 225100000X.