Individual provider Active NPI

Cheryl Estelle Burnside, PT

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1053442632
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
001758 Issued in GA
Practice address
600 W Peachtree St NW
Suite 180
Atlanta, GA 30308-3607
Phone
(404) 607-1741
NPI assigned
Mar 8, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 001758 GA Primary

Addresses

Primary practice location

600 W Peachtree St NW
Suite 180
Atlanta, GA 30308-3607

Mailing address

255 Maple Shade Dr
Tyrone, GA 30290-2815
Phone (770) 632-8508

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
001758GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Onsite Rehab Inc. PastSince Jul 12, 2004 Accepting new patients

Organizations & group practices 1

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": "1173312000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1053442632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "255 MAPLE SHADE DR",
            "city": "TYRONE",
            "state": "GA",
            "postal_code": "302902815",
            "telephone_number": "770-632-8508"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W PEACHTREE ST NW",
            "address_2": "SUITE 180",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303083607",
            "telephone_number": "404-607-1741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURNSIDE",
        "first_name": "CHERYL",
        "middle_name": "ESTELLE",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-08",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "001758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.