Individual provider Active NPI

Emily Mendonca, DPT

  • Physical Therapist
  • Rome, GA
National Provider Identifier
1144024365
Registry record updated Apr 4, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT014942 Issued in GA
Practice address
314 E 1St Ave
Rome, GA 30161-3216
Phone
(706) 314-8504
NPI assigned
Apr 4, 2025
Last updated
Apr 4, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 4, 2025

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 PT014942 GA Primary

Addresses

Primary practice location

314 E 1St Ave
Rome, GA 30161-3216

Mailing address

520 E 8TH St SE
Rome, GA 30161-6208
Phone (706) 513-0966

Other names 1

  • Emily Nash Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250418001379 GA Practitioner - Physical Therapist in Private Practice 0446775712 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Shift Mobile Therapy and Wellness, LLCGroup PAC ID 9739519836, 6 clinicians

Practice addresses (Care Compare)

314 E 1St Ave
Suite 701
Rome, GA 30161-3216
Phone (706) 314-8504

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Shift Mobile Therapy and Wellness, LLC Physical Therapist CurrentSince Apr 14, 2025 Accepting new patients

Locations

314 E 1st Ave
Rome, GA 30161
Phone (706) 314-8504

314 E 1st Ave
#701
Rome, GA 30161
Phone (706) 314-8504

Organizations & group practices 1

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": "1743724800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743724800000",
    "number": "1144024365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 E 8TH ST SE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301616208",
            "telephone_number": "706-513-0966"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "314 E 1ST AVE",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301613216",
            "telephone_number": "706-314-8504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MENDONCA",
        "first_name": "EMILY",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-04-04",
        "last_updated": "2025-04-04",
        "certification_date": "2025-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014942",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "EMILY",
            "last_name": "NASH",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Apr 4, 2025; 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.