Jital J Pancholi

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT010003 Issued in GA

Practice address

2450 Atlanta Hwy Ste 604
Cumming, GA 30040-1254

Phone

(404) 225-2174

Fax

(706) 995-6862

NPI assigned

Sep 29, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Jital P Shah Former name

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

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.

• Oncore Physical Therapy

  • Physical Therapy Clinic/Center
  • Cumming, GA
  • NPI 1669162939

  Orthopedic

  Medicare reassignment NPD Authorized official
• Activcore Health Network LLC

  • Physical Therapy Clinic/Center
  • Princeton, NJ
  • NPI 1659784767

  Orthopedic

  NPD

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

{
    "created_epoch": "1285718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683676800000",
    "number": "1093024747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2450 ATLANTA HWY STE 604",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300401254",
            "telephone_number": "404-225-2174",
            "fax_number": "706-995-6862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2450 ATLANTA HWY STE 604",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300401254",
            "telephone_number": "404-225-2174",
            "fax_number": "706-995-6862"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5775 Old Winder Hwy",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305171603",
            "country_code": "US",
            "telephone_number": "678-866-4104",
            "fax_number": "678-866-4104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5775 Old Winder Hwy",
            "address_purpose": "LOCATION",
            "city": "Braselton",
            "state": "GA",
            "postal_code": "305171603",
            "country_code": "US",
            "telephone_number": "678-866-4104",
            "fax_number": "678-866-4104",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3875 Johns Creek Pkwy",
            "address_purpose": "LOCATION",
            "city": "Suwanee",
            "state": "GA",
            "postal_code": "300241294",
            "country_code": "US",
            "telephone_number": "770-814-2986",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PANCHOLI",
        "first_name": "JITAL",
        "middle_name": "J",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-29",
        "last_updated": "2023-05-10",
        "certification_date": "2023-05-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "GA",
            "license": "PT010003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JITAL",
            "last_name": "SHAH",
            "middle_name": "P",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Lauren Palumbo
• Jessica Pamperin, MS, CCC-SLP
• Meghan Shelton Panagopoulos, OTR/L
• Mariah Lee Marie Panasyuk
• Dipali Panchal, RDN, LDN
• Pavani Kumari Pandiri, M.D
• Emily Pangrazio
• Eugene Stephen Paouncic Jr., D.C.
• Michelle Paras, LPC
• Deepali Parikh, PHARM.D.

• Orthopedic Physical Therapist in Cumming, GA
• Providers in Cumming, GA by specialty
• Orthopedic Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.