Individual provider Active NPI

Lori Reethof

  • Physical Therapist
  • Marietta, GA
National Provider Identifier
1104459205
Registry record updated Feb 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2572 Issued in GA
Practice address
630 Gunby Rd SE
Marietta, GA 30067-5132
Phone
(770) 630-6695
NPI assigned
Feb 17, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 17, 2020

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 2572 GA Primary

Addresses

Primary practice location

630 Gunby Rd SE
Marietta, GA 30067-5132

Mailing address

630 Gunby Rd SE
Marietta, GA 30067-5132
Phone (770) 630-6695

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230411000198 GA Practitioner - Physical Therapist in Private Practice 2163897802 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1987
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Physical Therapy, LLCGroup PAC ID 1153382676, 96 clinicians
Georgia Luna Care Physical Therapy LLCGroup PAC ID 4082027727, 167 clinicians

Practice addresses (Care Compare)

21 Ortho LN
Atlanta, GA 30329-2315
Phone (404) 778-3350

260 Peachtree St NW
Suite 2200
Atlanta, GA 30303-1292
Phone (866) 525-3175

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
85.59
Improvement activities
40
Cost
69.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2572GAMDElectroneurodiagnostic Specialist/Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Luna Care Physical Therapy LLC Physical Therapist CurrentSince Feb 21, 2023 Accepting new patients
Emory Physical Therapy, LLC CurrentSince May 31, 2023 Accepting new patients
Emory Physical Therapy, LLC CurrentSince May 31, 2023 Accepting new patients
Emory Physical Therapy, LLC Current Accepting new patients

Locations

21 Ortho Ln
Atlanta, GA 30329
Phone (404) 778-2516

260 Peachtree St NW
Ste 2200
Atlanta, GA 30303
Phone (669) 231-6870

21 Ortho Ln
Fl 1
Atlanta, GA 30329

1845 Satellite Blvd
Ste 750
Duluth, GA 30097
Phone (404) 778-6490

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": "1581897600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1581897600000",
    "number": "1104459205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 GUNBY RD SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300675132",
            "telephone_number": "770-630-6695"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 GUNBY RD SE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300675132",
            "telephone_number": "770-630-6695"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REETHOF",
        "first_name": "LORI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-17",
        "last_updated": "2020-02-17",
        "certification_date": "2020-02-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "2572",
            "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 Feb 17, 2020; 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.