Individual provider Active NPI

Bethany Davidson

  • Physical Therapist
  • Norcross, GA
National Provider Identifier
1073246708
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT015967 Issued in GA
Practice address
6050 Peachtree Pkwy Ste 410
Norcross, GA 30092-3337
Phone
(770) 441-1276
NPI assigned
Jul 9, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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 PT015967 GA Primary
Physical Therapist 225100000X GA

Addresses

Primary practice location

6050 Peachtree Pkwy Ste 410
Norcross, GA 30092-3337

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (866) 518-0283

Other practice location 1

3945 Holcomb Bridge Rd Ste 100
Norcross, GA 30092-5200
Phone (770) 840-8045

Other practice location 2

2612 Silverado Trl
Sherman, TX 75092-4520
Phone (580) 380-6999

Electronic endpoints 1

TypeEndpointUseAffiliation
SOAP URL bethanydavidson1 Direct

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240205001130 GA Practitioner - Physical Therapist in Private Practice 1850734138 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Georgia Luna Care Physical Therapy LLCGroup PAC ID 4082027727, 167 clinicians

Practice addresses (Care Compare)

260 Peachtree St NW
Suite 2200
Atlanta, GA 30303-1292
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT015967GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy, Inc CurrentSince Jan 8, 2024 Accepting new patients
Atlanta South Physical Therapy, Inc Physical Therapist CurrentSince Jan 8, 2024 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Jan 8, 2024 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Jan 8, 2024 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jan 8, 2024 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Jan 8, 2024 Accepting new patients

Locations

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

2255 Peachtree Rd NE
Ste G
Atlanta, GA 30309
Phone (404) 351-3257

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

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

3460 Sandy Plains Rd
Unit 610
Marietta, GA 30066
Phone (678) 631-5878

6050 Peachtree Pkwy
Ste 410
Norcross, GA 30092
Phone (770) 441-1276

Organizations & group practices 7

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": "1657324800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704412800000",
    "number": "1073246708",
    "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": "866-518-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6050 PEACHTREE PKWY STE 410",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300923337",
            "telephone_number": "770-441-1276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3945 Holcomb Bridge Rd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Norcross",
            "state": "GA",
            "postal_code": "300925200",
            "country_code": "US",
            "telephone_number": "770-840-8045",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2612 Silverado Trl",
            "address_purpose": "LOCATION",
            "city": "Sherman",
            "state": "TX",
            "postal_code": "750924520",
            "country_code": "US",
            "telephone_number": "580-380-6999",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "DAVIDSON",
        "first_name": "BETHANY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-09",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT015967",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "bethanydavidson1",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "2612 Silverado Trl",
            "city": "Sherman",
            "state": "TX",
            "country_code": "US",
            "postal_code": "750924520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; 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.