Individual provider Active NPI

Pamela Elene Gjerde, PT

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1073623666
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
57 Executive Park South NE
Ste 190
Atlanta, GA 30329-2288
Phone
(404) 778-6390
Fax
(404) 778-6340
NPI assigned
Aug 30, 2006
Last updated
Jul 8, 2007By the provider in NPPES
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 Primary

Addresses

Primary practice location

57 Executive Park South NE
Ste 190
Atlanta, GA 30329-2288

Mailing address

6308 Druid Hills Reserve Dr NE
Atlanta, GA 30329-2056
Phone (678) 371-3688

Other identifiers 1

IdentifierTypeStateIssuer
PT008073OtherGALICENSE #

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070106000097 GA Practitioner - Physical Therapist in Private Practice 8729088208 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Duke University School of Medicine, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Physical Therapy, LLCGroup PAC ID 1153382676, 96 clinicians

Practice addresses (Care Compare)

1845 Satellite Blvd
Suite 750
Duluth, GA 30097-4005
Phone (404) 778-6490

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Physical Therapy, LLC CurrentSince Mar 9, 2015 Accepting new patients
Emory Physical Therapy, LLC Current Accepting new patients
Emory Physical Therapy, LLC Physical Therapist CurrentSince Mar 9, 2015 Accepting new patients
Emory Physical Therapy, LLC Past Accepting new patients

Locations

57 Executive Park South NE
Ste 190
Atlanta, GA 30329
Phone (404) 778-6390

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

Organizations & group practices 4

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": "1156896000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1073623666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6308 DRUID HILLS RESERVE DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292056",
            "telephone_number": "678-371-3688"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "57 EXECUTIVE PARK SOUTH NE",
            "address_2": "STE 190",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292288",
            "telephone_number": "404-778-6390",
            "fax_number": "404-778-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GJERDE",
        "first_name": "PAMELA",
        "middle_name": "ELENE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE #",
            "identifier": "PT008073",
            "state": "GA"
        }
    ],
    "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.
  • 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.