Individual provider Active NPI

Mendi Michelle Schubert, PT

  • Physical Therapist
  • Loganville, GA
National Provider Identifier
1144315078
Registry record updated Jun 25, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT005934 Issued in GA
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

Updated by the provider on Jun 25, 2008

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 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

IdentifierTypeStateIssuer
GRP PIN 821337OtherGABLUE CROSS BLUE SHIELD
GRP4351OtherGAMEDICARE
582654830OtherGABLUE CROSS BLUE SHIELD
1386659894OtherPROMOTION 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

LicenseStateTypeSpecialty
PT005934GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Promotion Physical Therapy Inc Past Accepting new patients
Aica Orthopedics, P. C. Past Accepting new patients
Activcore Health Network LLC Physical Therapist PastSince Apr 1, 2022 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 PastSince Apr 1, 2013 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.

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.

Verify at the official NPI Registry.