Individual provider Active NPI

Treven Cliatt

  • Physical Therapist
  • Marietta, GA
National Provider Identifier
1093522609
Registry record updated Dec 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT017525 Issued in GA
Practice address
4880 Lower Roswell Rd Ste 625
Marietta, GA 30068-4390
Phone
(678) 809-8443
NPI assigned
Dec 17, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT017525 GA Primary

Addresses

Primary practice location

4880 Lower Roswell Rd Ste 625
Marietta, GA 30068-4390

Mailing address

6562 Patriot Dr
Columbus, GA 31909-4457
Phone (706) 604-9988

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

LicenseStateTypeSpecialty
PT017525GAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1734393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734393600000",
    "number": "1093522609",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6562 PATRIOT DR",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319094457",
            "telephone_number": "706-604-9988"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4880 LOWER ROSWELL RD STE 625",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300684390",
            "telephone_number": "678-809-8443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLIATT",
        "first_name": "TREVEN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-12-17",
        "last_updated": "2024-12-17",
        "certification_date": "2024-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT017525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2024; 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.