Active NPI
Mendi Michelle Schubert, PT
- Physical Therapist
- Loganville, GA
National Provider Identifier
1144315078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT005934
- Practice address
- 3890 Highway 81 South
Loganville, GA 30052-3917 - Phone
- (770) 554-7977
- Fax
- (770) 554-4177
- NPI assigned
- Oct 4, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT005934 | GA | Primary |
Addresses
Primary practice location
3890 Highway 81 South
Loganville, GA 30052-3917
Mailing address
3890 Highway 81 South
Loganville, GA 30052-3917
Phone (770) 972-5159
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| GRP PIN 821337 | Other | GA | BLUE CROSS BLUE SHIELD |
| GRP4351 | Other | GA | MEDICARE |
| 582654830 | Other | GA | BLUE CROSS BLUE SHIELD |
| 1386659894 | Other | PROMOTION PHYSICAL THERAPY FACILITY NPI |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT005934 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Promotion Physical Therapy Inc | Past | Accepting new patients | |
| Aica Orthopedics, P. C. | Past | Accepting new patients | |
| Activcore Health Network LLC | Physical Therapist | Past | Accepting new patients |
| Aica Orthopedics, P.C. | Past | Accepting new patients | |
| Aica Orthopedics, P.C. | Past | Accepting new patients | |
| Meadows Hand and Physical Therapy Clinic | Physical Therapist | Past | Accepting new patients |
| Rehab Health Partners, Inc. | Physical Therapist | Past | Accepting new patients |
| Aica Orthopedics, P. C. | Past | Accepting new patients |
Organizations & group practices 8
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.
-
- Clinic/Center
- Stone Mountain, GA
- NPI 1528640737
-
- Multi-Specialty Clinic/Center
- Kennesaw, GA
- NPI 1730532698
-
- Multi-Specialty Clinic/Center
- Lithia Springs, GA
- NPI 1740692342
-
- Clinic/Center
- Atlanta, GA
- NPI 1841708682
-
dba Meadows Physical Therapy and Hand Clinic
- Hand Physical Therapist
- Johns Creek, GA
- NPI 1063620037
-
- Specialist
- Loganville, GA
- NPI 1386659894
-
dba Activcore
- Physical Therapy Clinic/Center
- Princeton, NJ
- NPI 1659784767
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1214352000000",
"number": "1144315078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3890 HIGHWAY 81 SOUTH",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300523917",
"telephone_number": "770-972-5159"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3890 HIGHWAY 81 SOUTH",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300523917",
"telephone_number": "770-554-7977",
"fax_number": "770-554-4177"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SCHUBERT",
"first_name": "MENDI",
"middle_name": "MICHELLE",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-10-04",
"last_updated": "2008-06-25",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT005934",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "GRP PIN 821337",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE",
"identifier": "GRP4351",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "582654830",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PROMOTION PHYSICAL THERAPY FACILITY NPI",
"identifier": "1386659894",
"state": null
}
],
"endpoints": [],
"other_names": []
}
Other providers in Loganville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.