Individual provider Active NPI

Carolyn M Lawson, PT

  • Physical Therapist
  • Marietta, GA
National Provider Identifier
1104000439
Registry record updated Sep 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
003709 Issued in GA
Practice address
1163 Johnson Ferry Rd
Suite 100
Marietta, GA 30068-2764
Phone
(770) 321-0155
Fax
(770) 321-8426
NPI assigned
Dec 21, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2008

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 003709 GA Primary

Addresses

Primary practice location

1163 Johnson Ferry Rd
Suite 100
Marietta, GA 30068-2764

Mailing address

1163 Johnson Ferry Rd
Suite 100
Marietta, GA 30068-2764
Phone (770) 321-0155

Other identifiers 1

IdentifierTypeStateIssuer
650016944OtherGAMEDICARE RAILROAD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080904000171 GA Practitioner - Physical Therapist in Private Practice 0446292510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

89 Hiawassee Park Dr
Hiawassee, GA 30546-2173
Phone (470) 275-5015

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
003709GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Neurosport Physical Therapy Current Accepting new patients
Neurosport Physical Therapy & Rehabilitation Specialist Inc. Physical Therapist CurrentSince Oct 15, 1996 Accepting new patients
Kennestone Hospital, Inc Past Accepting new patients
Neurosport Physical Therapy@Ellard LLC. Physical Therapist Past Accepting new patients

Locations

3365 Piedmont Rd NE
Ste 1260
Atlanta, GA 30305
Phone (404) 504-9030

1163 Johnson Ferry Rd
Ste 100
Marietta, GA 30068
Phone (770) 321-0155

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1198195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221091200000",
    "number": "1104000439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1163 JOHNSON FERRY RD",
            "address_2": "SUITE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300682764",
            "telephone_number": "770-321-0155",
            "fax_number": "770-321-8426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1163 JOHNSON FERRY RD",
            "address_2": "SUITE 100",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300682764",
            "telephone_number": "770-321-0155",
            "fax_number": "770-321-8426"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWSON",
        "first_name": "CAROLYN",
        "middle_name": "M",
        "name_prefix": "Mrs.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-21",
        "last_updated": "2008-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "003709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "650016944",
            "state": "GA"
        }
    ],
    "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 Sep 11, 2008; 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.