Individual provider Active NPI

Bethany Lynn Nelson, PT, DPT

  • Physical Therapist
  • Peachtree City, GA
National Provider Identifier
1063715514
Registry record updated May 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
006835 Issued in GA
Practice address
313 Dividend Dr Ste 100313
Peachtree City, GA 30269-1949
Phone
(404) 488-5342
Fax
(470) 264-7102
NPI assigned
Dec 6, 2010
Last updated
May 31, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 31, 2025

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 006835 GA Primary
Physical Therapist 225100000X PT006835 GA

Addresses

Primary practice location

313 Dividend Dr Ste 100313
Peachtree City, GA 30269-1949

Mailing address

313 Dividend Dr Ste 100
Peachtree City, GA 30269-1916
Phone (404) 488-5342

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110427000063 GA Practitioner - Physical Therapist in Private Practice 0446435911 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

313 Dividend Dr
Suite 300
Peachtree City, GA 30269-1934
Phone (404) 488-5342

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006835GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Fox Rehabilitation Ga, LLC Physical Therapist CurrentSince Jan 1, 2025 Accepting new patients
Bethany Nelson PT DPT LLC Physical Therapist Current Accepting new patients
Bethany Nelson PT DPT LLC Single Specialty CurrentSince Feb 10, 2025 Accepting new patients
Progressivehealth Rehabilitation Solutions, Inc CurrentSince Jan 17, 2022 Accepting new patients
Progressivehealth Rehabilitation Solutions, Inc Single Specialty PastSince Jan 1, 2022 Accepting new patients

Locations

1777 Georgian Park
Peachtree City, GA 30269
Phone (770) 487-1931

313 Dividend Dr
Ste 300
Peachtree City, GA 30269
Phone (404) 488-5342

7 Carnegie Plz
Cherry Hill, NJ 08003

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, 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": "1291593600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748649600000",
    "number": "1063715514",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "313 DIVIDEND DR STE 100",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691916",
            "telephone_number": "404-488-5342",
            "fax_number": "470-264-7102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "313 DIVIDEND DR STE 100313",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302691949",
            "telephone_number": "404-488-5342",
            "fax_number": "470-264-7102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "BETHANY",
        "middle_name": "LYNN",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-06",
        "last_updated": "2025-05-31",
        "certification_date": "2025-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "006835",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT006835",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree City, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2025; 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.