Jessica Childress, PT, DPT
Individual provider Active NPI Physical Therapist · Dahlonega, GA
NPI 1124689799 · NPPES record last updated Nov 4, 2024
Key facts
- NPI
- 1124689799
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT014068 (GA)
- Practice address
- 420 Walmart Way Ste B
Dahlonega, GA 30533-0818 - Phone
- (706) 482-2268
- Fax
- (706) 482-2294
- NPI assigned
- Jun 25, 2019
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 11
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Independent Physical Therapy of Georgia, LLC
Practice addresses (Care Compare)
420 Walmart Way
Suite B
Dahlonega, GA 30533-0818
Phone (706) 482-2268
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20190808002730 | GA | Practitioner - Physical Therapist in Private Practice | 8325375694 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT014068 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Independent Physical Therapy of Georgia, LLC | Physical Therapist | Current |
Accepting new patients |
| Independent Physical Therapy of Georgia, LLC | Physical Therapist | Current |
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
916 Loganville Hwy
Ste 1130
Bethlehem, GA 30620
Phone (404) 671-9525
420 Walmart Way
#B
Dahlonega, GA 30533
Phone (706) 482-2268
6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT014068 | GA | Yes |
Addresses
Primary practice location
420 Walmart Way Ste B
Dahlonega, GA 30533-0818
Mailing address
1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (866) 518-0283
Other names
- Jessica Taylor
Other providers in Dahlonega, GA
- Mycala Cherry
- Chestatee Counseling Center
- Chestatee Emergency Physicians, LLC
- Chestatee Surgical Associates
- Suzanne A Childers
- Chita Eye Associates P.C.
- Hyerin Chung
- John M Clagett
- Cheryl Beth Clark
- Eddie Sue Cleveland
All providers in Dahlonega, GA · Physical Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 4, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.