Active NPI
Yolanda Trenett Jackson, PTA
- Physical Therapy Assistant
- Atlanta, GA
National Provider Identifier
1073904587
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA002327
- Practice address
- 400 Embassy Row
Suite 125
Atlanta, GA 30328-1667 - Phone
- (770) 225-8421
- Fax
- (866) 587-9993
- NPI assigned
- Feb 5, 2015
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapy Assistant | 225200000X | PTA002327 | GA | Primary |
Addresses
Primary practice location
400 Embassy Row
Suite 125
Atlanta, GA 30328-1667
Mailing address
4201 Weems Rd
Columbus, GA 31909-3279
Phone (706) 905-9256
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTA002327 | GA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1423094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1423094400000",
"number": "1073904587",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4201 WEEMS RD",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319093279",
"telephone_number": "706-905-9256"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "400 EMBASSY ROW",
"address_2": "SUITE 125",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303281667",
"telephone_number": "770-225-8421",
"fax_number": "866-587-9993"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JACKSON",
"first_name": "YOLANDA",
"middle_name": "TRENETT",
"credential": "PTA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-02-05",
"last_updated": "2015-02-05",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "GA",
"license": "PTA002327",
"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 Feb 5, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.