CMS-1500 Box 24J / 33a • NPI
1073983953
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
225100000X (CMS 65)
Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist
Box 32 Service Location & ZIP+4
348 BIG A RD, TOCCOA, GA, 30577
Official NPPES Practice Location
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1073983953 (ACTIVEKIDZ AND ADULT THERAPY SERVICES) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1073983953 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ACTIVEKIDZ AND ADULT THERAPY SERVICES |
| Plain-English Specialty | Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist NUCC Code: 225100000X (Physical Therapist) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 348 BIG A RD, TOCCOA, GA, 30577 |
| Practice Telephone / Fax | Tel: (770) 207-6390 |
| Administrative Mailing Address | 1431 CAPITAL AVE, WATKINSVILLE, GA, 30677-1883 |
| Enumeration & Last Sync | Enumerated: 2015-10-05 | CMS Record Updated: 2024-04-25 |
| Authorized Official | SUSAN COOK (Owner) |
Clinic Location, Accessibility & Directions
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Plain-English Taxonomy & CMS Crosswalk (225100000X)
What Does Taxonomy Code 225100000X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 225100000X translates to:
"Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ACTIVEKIDZ AND ADULT THERAPY SERVICES)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
225100000X — Physical TherapistPlain English: Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist | State: GA | License: 5588 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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