RENEE R MADDUX (NPI# 1063572808) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1063572808 |
| Entity Type | Individual |
| Full Name | RENEE R MADDUX |
| Credential | PT |
| Practice Address |
1055 Thomas Rd Canton GA 30115-6702 |
| Mailing Address |
325 Waverly Hall Cir Roswell GA 30075-2110 |
| Practice Telephone | 6787360724 |
| Practice Fax Number | 6787360724 |
| Mailing Telephone | 6782779966 |
| Mailing Fax Number | 6782779966 |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2009-06-01 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225100000X | Physical Therapist | 6052 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
6052 | GA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | AMERIGROUP | 10040447 | 01 |
| GA | PHYSICAL THERAPY LICENSE | 6052 | 01 |
| GA | WELLCARE | 321993 | 01 |
| GA | 000885585A | 05 |
| Street Address |
1055 THOMAS RD |
| City | CANTON |
| State | GA |
| Zip Code | 30115-6702 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326274663 | Hippo Associates, LLC | Physical Therapist | 1055 Thomas Rd, Canton, GA 30115-6702 | 2009-06-01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497364806 | Amanda Arbogast | Speech-Language Pathologist | 610 Royal Crest Court, Canton, GA 30115 | 2020-07-31 |
| 1033754163 | Kelly Marie Shirley | Nurse Practitioner | 450 Northside Cherokee Blvd., Radiology Dept., Canton, GA 30115 | 2019-11-13 |
| 1700394319 | Jennifer Lynn Davenport | Nurse Practitioner | 684 Sixes Rd Ste 125, Holly Springs, GA 30115 | 2018-01-17 |
| 1851717961 | Wal-mart Stores East, Lp | Technician/Technologist | 2200 Holly Springs Pkey, Holly Springs, GA 30115 | 2014-03-13 |
| 1194148502 | Julia Bedingfield Reid | Pharmacist | 450 Northside Cherokee Blvd Ste T20, Canton, GA 30115 | 2014-01-22 |
| 1447597992 | America's Best Contacts & Eyeglasses | Technician/Technologist | 2030 Cumming Highway, Suite 106, Canton, GA 30115 | 2013-01-03 |
| 1679821193 | Jill M Decorso | Speech-Language Pathologist | 4280 Hickory Flat Hwy, Ste 108, Canton, GA 30115 | 2012-08-15 |
| 1306113378 | Sidney Boyd Collier IIi | Pharmacist | 6111 Hickory Flat Highway, Canton, GA 30115 | 2011-11-18 |
| 1174804702 | Rayllensons Itacy | Physician Assistant | 2020 Cumming Highway, Suite 102, Canton, GA 30115 | 2011-09-09 |
| 1245534346 | Kim M. Mcmillan | Counselor | 154 Lakeside Drive, Canton, GA 30115 | 2011-01-04 |
| Find all providers in zip 30115 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1184173874 | Hillary Lawrence | Physical Therapist | 428 33rd St Nw, Canton, OH 44709-3014 | 2016-09-23 |
| 1982937223 | Nimble Kids LLC | Physical Therapist | 200 Riverstone Dr, Suite B, Canton, GA 30114-5256 | 2009-09-17 |
| 1467633842 | Sonya L Larrieux | Physical Therapist | 125 Thoreau Rd, Canton, MA 02021-2494 | 2007-11-14 |
| 1093256109 | Hearts and Hands Therapy Services, Inc. | Physical Therapist | 709 Crescent Cir, Canton, GA 30115-4772 | 2017-03-09 |
| 1831590462 | Angela Rose Hiltbrand | Physical Therapist | 5156 Whipple Ave Nw, Canton, OH 44718-2663 | 2014-09-15 |
| 1659797298 | Cara E Clester | Physical Therapist | 5156 Whipple Ave Nw, Canton, OH 44718-2663 | 2014-03-06 |
| 1811310923 | Kathleen Conrad | Physical Therapist | 2100 38th St Nw, Canton, OH 44709-2312 | 2014-01-24 |
| 1730435777 | Alexandra Renee Larson | Physical Therapist | 5156 Whipple Ave Nw, Canton, OH 44718-2663 | 2012-07-27 |
| 1003114109 | Kids@home Therapy Services | Physical Therapist | 701 27th St Ne, Canton, OH 44714-1703 | 2011-03-14 |
| 1154623056 | Tracy Leigh Elliott | Physical Therapist | 139 State Street Rd, Canton, NY 13617-3504 | 2010-11-28 |
| Find all providers in CANTON | ||||
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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.