Individual provider Active NPI

Alison Lynn Olsen, PT, DPT

  • Physical Therapist
  • Canton, GA
National Provider Identifier
1003342924
Registry record updated Sep 15, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT014966 Issued in GA
Practice address
1453 Riverstone Pkwy Ste 170
Canton, GA 30114-5603
Phone
(770) 704-0774
Fax
(770) 704-0779
NPI assigned
May 11, 2017
Last updated
Sep 15, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070023208 IL
Physical Therapist 225100000X PT014966 GA Primary

Addresses

Primary practice location

1453 Riverstone Pkwy Ste 170
Canton, GA 30114-5603

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Other practice location 1

7148 W Higgins Ave
Chicago, IL 60656-1974
Phone (773) 360-5531

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210106001115 GA Practitioner - Physical Therapist in Private Practice 6406129758 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Sep 30, 2020 Accepting new patients
BJT & Associates Physical Therapist CurrentSince Nov 28, 2022 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Sep 30, 2020 Accepting new patients
BJT and Associates Physical Therapist PastSince Nov 28, 2022 Accepting new patients
Athletic Development and Performance Therapy Physical Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

2669 Osborne Rd NE
Brookhaven, GA 30319
Phone (404) 477-7777

2669 Osborne Rd NE
Ste A
Brookhaven, GA 30319
Phone (404) 477-4777

1453 Riverstone Pkwy
Ste 170
Canton, GA 30114
Phone (770) 704-0077

5342 Tilly Mill Rd
Dunwoody, GA 30338
Phone (678) 812-4031

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1494460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600128000000",
    "number": "1003342924",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1453 RIVERSTONE PKWY STE 170",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145603",
            "telephone_number": "770-704-0774",
            "fax_number": "770-704-0779"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7148 W Higgins Ave",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606561974",
            "country_code": "US",
            "telephone_number": "773-360-5531",
            "fax_number": "773-360-5538",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "OLSEN",
        "first_name": "ALISON",
        "middle_name": "LYNN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-11",
        "last_updated": "2020-09-15",
        "certification_date": "2020-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070023208",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014966",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.