Jessica Mashaun Bivins, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT012558 Issued in GA

Practice address

9390 The Landing Dr
Douglasville, GA 30135-7180

Phone

(770) 850-1692

NPI assigned

Aug 17, 2016

Last updated

Aug 17, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Elevate Physical Therapy and Wellness

  • Physical Therapy Clinic/Center
  • Lithia Springs, GA
  • NPI 1508522418
  NPD Authorized official
• Select Outpatient Services Inc

  • Rehabilitation Clinic/Center
  • Newcastle, WA
  • NPI 1285909531

  Physical Therapist

  NPD
• Jorge a. Bueno Chiropractic LLC

  • Nutrition Chiropractor
  • Acworth, GA
  • NPI 1962679340
  NPD (past)
• PT Solutions of Acworth, LLC

  • Physical Therapist
  • Watkinsville, GA
  • NPI 1679025167
  NPD (past)

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

{
    "created_epoch": "1471392000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471392000000",
    "number": "1114472388",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "916 MEADOWOOD LN",
            "address_2": "0916",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301358807",
            "telephone_number": "321-276-2353"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9390 THE LANDING DR",
            "city": "DOUGLASVILLE",
            "state": "GA",
            "postal_code": "301357180",
            "telephone_number": "770-850-1692"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIVINS",
        "first_name": "JESSICA",
        "middle_name": "MASHAUN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-17",
        "last_updated": "2016-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012558",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT30539",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Beulah Hepzibah Inc
• Bi-County ENT, LLC
• Bi-County Pediatrics
• Aaron Jarrod Bingham, PT, DPT
• Bio-Medical Applications of Georgia, Inc. (Fresenius Kidney Care Chapel Hill)
• Black Royal Beauty LLC
• Cassady Black
• Seth Blair
• Shakia Lynn Blake
• Rebecca S Blakeman, PHD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2016; 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.