Alyssa Daniele Antonicello

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

2030 Barrett Downs Dr
Cumming, GA 30040-9657

Phone

(859) 338-2772

NPI assigned

Dec 31, 2024

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Empowerme Rehabilitation Georgia, LLC

  • Multi-Specialty Clinic/Center
  • Cumming, GA
  • NPI 1952934374

  Physical Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1735603200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1736294400000",
    "number": "1003625492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 BARRETT DOWNS DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300409657",
            "telephone_number": "859-338-2772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 BARRETT DOWNS DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300409657",
            "telephone_number": "859-338-2772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANTONICELLO",
        "first_name": "ALYSSA",
        "middle_name": "DANIELE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-12-31",
        "last_updated": "2025-01-08",
        "certification_date": "2025-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "013299",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angels All Around Inc
• Angels of Georgia Inc
• Laura Jane Angley, LCSW
• Irfan Ansari, M.D.
• Rachel Kasin Anton, PA-C
• Anytime Physicians LLC
• Apex Professional Audiology, LLC
• Apollo Spine and Pain Center
• Elizabeth Phillips Appleby, LPC
• Amanda Gilleland Appling, PA-C

• Physical Therapist in Cumming, GA
• Providers in Cumming, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2025; 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.