Individual provider Active NPI

Dennis A Roesch, PT

  • Physical Therapist
  • Austell, GA
National Provider Identifier
1134138258
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT7904 Issued in GA
Practice address
1025 E West Connector # 4
Suite 406
Austell, GA 30106-8513
Phone
(770) 384-1001
Fax
(770) 384-0333
NPI assigned
Aug 7, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT7904 GA Primary

Addresses

Primary practice location

1025 E West Connector # 4
Suite 406
Austell, GA 30106-8513

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040510001539 GA Practitioner - Physical Therapist in Private Practice 8123017563 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
May accept Medicare assignment
Group practices
Aczi LLCGroup PAC ID 3870864861, 11 clinicians

Practice addresses (Care Compare)

6 N Avondale Rd
Avondale Estates, GA 30002-1319
Phone (470) 649-3626

Merit-based Incentive Payment System (MIPS)

Final score
94.9 of 100Reported as group
Promoting interoperability
94
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT7904GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Aczi, LLC CurrentSince Mar 17, 2025 Accepting new patients
Southern Health Corp of Ellijay Past Accepting new patients
Fitness Forum of Georgia Physical Therapist Past Accepting new patients
Peachtree Orthopaedic Clinic PA Physical Therapist Past Accepting new patients

Locations

2800 N Druid Hills Rd NE
Ste A100
Atlanta, GA 30329
Phone (470) 427-3840

6 N Avondale Rd
Avondale Estates, GA 30002
Phone (470) 649-3626

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1134138258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 E WEST CONNECTOR # 4",
            "address_2": "SUITE 406",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068513",
            "telephone_number": "770-384-1001",
            "fax_number": "770-384-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROESCH",
        "first_name": "DENNIS",
        "middle_name": "A",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT7904",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Austell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.