Individual provider Active NPI

Erica Monique Mattox, P.T.

  • Specialist
  • Lithonia, GA
National Provider Identifier
1083804363
Registry record updated Apr 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
004280 Issued in GA
Practice address
1450 Bentley Ridge CT
Lithonia, GA 30058-5677
Phone
(678) 640-9045
Fax
(770) 484-8534
NPI assigned
Aug 1, 2007
Last updated
Apr 21, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 21, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 004280 GA Primary
Physical Therapist 225100000X 04280 GA

Addresses

Primary practice location

1450 Bentley Ridge CT
Lithonia, GA 30058-5677

Mailing address

1450 Bentley Ridge CT
Lithonia, GA 30058-5677
Phone (678) 640-9045

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250606001008 GA Practitioner - Physical Therapist in Private Practice 3678083987 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Norcross, GA 30093
Phone (770) 279-6200

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
004280GAMDSpecialist
04280GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pruitthealth Therapy Services, Inc. Physical Therapist CurrentSince Mar 31, 2025 Accepting new patients

Locations

1626 Jeurgens Ct
Norcross, GA 30093
Phone (770) 806-6875

Organizations & group practices 1

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": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1776729600000",
    "number": "1083804363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1450 BENTLEY RIDGE CT",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300585677",
            "telephone_number": "678-640-9045",
            "fax_number": "770-484-8534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1450 BENTLEY RIDGE CT",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300585677",
            "telephone_number": "678-640-9045",
            "fax_number": "770-484-8534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MATTOX",
        "first_name": "ERICA",
        "middle_name": "MONIQUE",
        "name_prefix": "Mrs.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2026-04-21",
        "certification_date": "2026-04-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "004280",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "04280",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithonia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2026; 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.