Siobhan Breannan Pfaff

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT013575 Issued in GA

Practice address

12 Executive Park Dr NE
Atlanta, GA 30329-2206

Phone

(404) 778-7777

NPI assigned

Dec 17, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• PT Services

  • Orthopedic Physical Therapist
  • Chatham, NJ
  • NPI 1275958449
  NPD

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

{
    "created_epoch": "1545004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1545004800000",
    "number": "1093286965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 SILVER LAKE RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103012725",
            "telephone_number": "347-861-4968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12 EXECUTIVE PARK DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303292206",
            "telephone_number": "404-778-7777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PFAFF",
        "first_name": "SIOBHAN",
        "middle_name": "BREANNAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-17",
        "last_updated": "2018-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT013575",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GEORGIA STATE BOARD OF PHYSICAL THERAPY",
            "identifier": "PT013575",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cheri Pettway, PHLEBOTOMIST
• Quinnise Pettway, LPC
• Heather K Petty, RDN, LDN, MS
• Iman Pearline Pew, LCSW
• Tsvetomira Zhivkova Peykova
• Katherine Lohr Pfeifer, CNP
• Karen Pfeiffer
• Anna Pfister
• Varun Phadke, M.D.
• Elizabeth Huyen Pham

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.