Individual provider Active NPI

Clarissa Michel, DPT

  • Physical Therapist
  • Stockbridge, GA
National Provider Identifier
1003409673
Registry record updated Jul 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT015121 Issued in GA
Practice address
1060 Eagles Landing Pkwy Ste 130
Stockbridge, GA 30281-9091
Phone
(470) 369-5770
Fax
(470) 369-5771
NPI assigned
Feb 15, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 22, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT015121 GA Primary

Addresses

Primary practice location

1060 Eagles Landing Pkwy Ste 130
Stockbridge, GA 30281-9091

Mailing address

33900 Harper Ave Ste 104
Clinton TWP, MI 48035-4258
Phone (586) 350-2644

Other practice location 1

2168 Highway 20 W
McDonough, GA 30253-7205
Phone (470) 944-7550

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210512001825 GA Practitioner - Physical Therapist in Private Practice 7719396233 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
85.59
Improvement activities
40
Cost
69.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Physical Therapy, LLC CurrentSince Apr 22, 2023 Accepting new patients
Team Rehabilitation Services, LLC Physical Therapist CurrentSince Oct 25, 2021 Accepting new patients
Emory Physical Therapy, LLC CurrentSince Apr 22, 2023 Accepting new patients
Emory Physical Therapy, LLC Current Accepting new patients
Georgia Luna Care Physical Therapy LLC Physical Therapist CurrentSince Apr 17, 2023 Accepting new patients

Locations

21 Ortho Ln
Atlanta, GA 30329
Phone (404) 778-2516

260 Peachtree St NW
Ste 2200
Atlanta, GA 30303
Phone (669) 231-6870

21 Ortho Ln
Fl 1
Atlanta, GA 30329

1288 Wellbrook Cir NE
Ste B
Conyers, GA 30012
Phone (678) 487-5920

1845 Satellite Blvd
Ste 750
Duluth, GA 30097
Phone (404) 778-6490

975 Dawsonville Hwy
Ste 6
Gainesville, GA 30501
Phone (470) 768-8100

2168 Highway 20 W
McDonough, GA 30253
Phone (470) 944-7550

1060 Eagles Landing Pkwy
Ste 130
Stockbridge, GA 30281
Phone (470) 369-5770

33900 Harper Ave
Ste 104
Clinton Twp, MI 48035
Phone (586) 416-9100

Organizations & group practices 5

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

NPI Registry JSON

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

{
    "created_epoch": "1613347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626912000000",
    "number": "1003409673",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-350-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 EAGLES LANDING PKWY STE 130",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819091",
            "telephone_number": "470-369-5770",
            "fax_number": "470-369-5771"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2168 Highway 20 W",
            "address_purpose": "LOCATION",
            "city": "McDonough",
            "state": "GA",
            "postal_code": "302537205",
            "country_code": "US",
            "telephone_number": "470-944-7550",
            "fax_number": "470-944-7551",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICHEL",
        "first_name": "CLARISSA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-15",
        "last_updated": "2021-07-22",
        "certification_date": "2021-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT015121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stockbridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.