Simon Chang, PT, DPT

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

License

PT016743 Issued in GA

Practice address

2456 Summeroak Dr
Tucker, GA 30084-3453

Phone

(706) 810-0065

NPI assigned

Dec 16, 2024

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Georgia Luna Care Physical Therapy LLCGroup PAC ID 4082027727, 167 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Georgia Luna Care Physical Therapy LLC

  • Physical Therapist
  • Atlanta, GA
  • NPI 1245826999

  Physical Therapy

  Medicare reassignment Care Compare group NPD
• Emory Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Atlanta, GA
  • NPI 1922018423
  Medicare reassignment NPD
• Emory Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Lithonia, GA
  • NPI 1346119831
  NPD
• Emory Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Brookhaven, GA
  • NPI 1720097561
  NPD

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

{
    "created_epoch": "1734307200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734307200000",
    "number": "1134936982",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2887 MALTON WAY",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300521112",
            "telephone_number": "770-231-5842"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2456 SUMMEROAK DR",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300843453",
            "telephone_number": "706-810-0065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHANG",
        "first_name": "SIMON",
        "name_prefix": "Dr.",
        "credential": "PT, DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-12-16",
        "last_updated": "2024-12-16",
        "certification_date": "2024-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "GA",
            "license": "PT016743",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Chambers
• Sharde Fontaine Chambers, D.O.
• Caitlin Chamblee, DPT
• Brendon Chan, PT, DPT
• Sandeep Chandra, MD FACC
• Sally Ann Chapman Phillips, PT
• Grace Charles
• Chandra Charlotin, APRN, FNP-C
• Samvel Artavazovich Charukhchian, M.D., PH.D.
• Harry McClure Chase, DDS

• Physical Therapy Clinic/Center in Tucker, GA
• Providers in Tucker, GA by specialty
• Physical Therapy Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 16, 2024; 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.