Individual provider Active NPI

Shelly Stein Peller, PT

  • Physical Therapist
  • Rome, GA
National Provider Identifier
1124029780
Registry record updated May 8, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT001302 Issued in GA
Practice address
1825 Martha Berry Blvd NW
Rome, GA 30165-1625
Phone
(762) 235-2700
Fax
(706) 236-6437
NPI assigned
Aug 4, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 8, 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 PT001302 GA Primary

Addresses

Primary practice location

1825 Martha Berry Blvd NW
Rome, GA 30165-1625

Mailing address

221 Technology Pkwy NW
Rome, GA 30165-1369
Phone (762) 235-1038

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address shelly.peller.1@1498.direct.athenahealth.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160928000600 GA Practitioner - Physical Therapist in Private Practice 6608163027 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1980
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Harbin Clinic LLCGroup PAC ID 0446154231, 238 clinicians

Practice addresses (Care Compare)

330 Turner McCall Blvd SW
Rome, GA 30165-5616
Phone (762) 235-2710

Merit-based Incentive Payment System (MIPS)

Final score
83.23 of 100Reported as group
Quality
65.74
Promoting interoperability
100
Improvement activities
40
Cost
78.37

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Sep 1, 2016 Accepting new patients
Harbin Clinic, LLC Current Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Sep 1, 2016 Accepting new patients
Harbin Clinic, LLC CurrentSince Dec 30, 2019 Accepting new patients
Harbin Clinic, LLC Physical Therapist CurrentSince Dec 30, 2019 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

150 Gentilly Blvd
Cartersville, GA 30120
Phone (678) 719-7000

1825 Martha Berry Blvd NW
Rome, GA 30165
Phone (706) 238-8073

221 Technology Pkwy NW
Rome, GA 30165
Phone (762) 235-1000

330 Turner McCall Blvd SW
Rome, GA 30165
Phone (706) 802-2000

463 Turner McCall Blvd NE
Rome, GA 30165
Phone (706) 378-3124

11490 Alpharetta Hwy
Ste 200
Roswell, GA 30076
Phone (770) 740-8592

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

8823 Production Ln
Ooltewah, TN 37363
Phone (423) 238-8923

Interoperability endpoints

  • Direct secure messaging: shelly.peller.1@1498.direct.athenahealth.com

Organizations & group practices 5

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": "1123113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1588896000000",
    "number": "1124029780",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "221 TECHNOLOGY PKWY NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651369",
            "telephone_number": "762-235-1038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1825 MARTHA BERRY BLVD NW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301651625",
            "telephone_number": "762-235-2700",
            "fax_number": "706-236-6437"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLER",
        "first_name": "SHELLY",
        "middle_name": "STEIN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-04",
        "last_updated": "2020-05-08",
        "certification_date": "2020-05-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT001302",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "shelly.peller.1@1498.direct.athenahealth.com",
            "affiliation": "N",
            "address_1": "1825 Martha Berry Blvd NW",
            "city": "Rome",
            "state": "GA",
            "country_code": "US",
            "postal_code": "301651625",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 8, 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.