Nsikak Alex Essienumoh, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT9924 Issued in GA

Practice address

3056 Anvil Block Rd
Suite 118
Ellenwood, GA 30294

Phone

(404) 366-8100

Fax

(404) 366-8106

NPI assigned

May 24, 2010

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2008

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Entelechy Rehab, LLCGroup PAC ID 0547549131, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Entelechy Rehab, LLC

  • Physical Therapy Clinic/Center
  • Conley, GA
  • NPI 1881063576
  Medicare reassignment Care Compare group NPD Authorized official

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

{
    "created_epoch": "1274659200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463443200000",
    "number": "1073832598",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3056 ANVIL BLOCK RD",
            "address_2": "SUITE 118",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "30294",
            "telephone_number": "404-366-8100",
            "fax_number": "404-366-8106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3056 ANVIL BLOCK RD",
            "address_2": "SUITE 118",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "30294",
            "telephone_number": "404-366-8100",
            "fax_number": "404-366-8106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ESSIENUMOH",
        "first_name": "NSIKAK",
        "middle_name": "ALEX",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-05-24",
        "last_updated": "2016-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT9924",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Francine Ellis, MPT
• Ashlee Eltayeb
• Danielle Monique' Emina, LPC
• Espresso Culture
• Essential Touch Self Care, LLC
• Fairview Chiropractic Center
• Fairview Chiropractic Center, LLC
• Fairview Dental LLC
• Fairview Urgent Care, LLC
• Arthur Ivey Few

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 17, 2016; 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.