Andrew Maddox
Physical Therapist in Covington, GA. Individual provider (NPI-1).
NPI number1164081220
StatusActive
Last updated in NPPESOct 15, 2022
Details
- NPI
- 1164081220
- Entity type
- Individual (NPI-1)
- Name
- Andrew Maddox
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Jun 11, 2019
- Certification date
- Oct 15, 2022
- Last updated
- Oct 15, 2022
Medicare and OIG
- Medicare enrolled (PECOS)
- Not in the Medicare enrollment file
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | PT014006 | GA | Yes |
Practice location
9152 Highway 278 NeCovington, GA 30014-7010
Phone 678-342-9339
Mailing address
5257 Hearthstone StStone Mountain, GA 30083-3605
Phone 678-713-6095
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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All 33 Physical Therapist providers in Covington · All 1,316 providers in Covington
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