Individual provider Active NPI

Denise Marie Powell, PT

  • Physical Therapist
  • Roswell, GA
National Provider Identifier
1154523678
Registry record updated Jun 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT007668 Issued in GA
Practice address
45 W. Crossville Road, Suite 514
Roswell, GA 30075-2964
Phone
(770) 642-9444
Fax
(855) 223-5462
NPI assigned
Jun 5, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 7, 2012

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 PT007668 GA Primary

Addresses

Primary practice location

45 W. Crossville Road, Suite 514
Roswell, GA 30075-2964

Mailing address

45 W. Crossville Road, Suite 514
Roswell, GA 30075-2964
Phone (770) 642-9444

Other identifiers 2

IdentifierTypeStateIssuer
282006299DMedicaidGA
898718498AMedicaidGA

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

NPI Registry JSON

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

{
    "created_epoch": "1181001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339027200000",
    "number": "1154523678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "45 W. CROSSVILLE ROAD, SUITE 514",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300752964",
            "telephone_number": "770-642-9444",
            "fax_number": "855-223-5462"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 W. CROSSVILLE ROAD, SUITE 514",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300752964",
            "telephone_number": "770-642-9444",
            "fax_number": "855-223-5462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POWELL",
        "first_name": "DENISE",
        "middle_name": "MARIE",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-06-05",
        "last_updated": "2012-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT007668",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "282006299D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "898718498A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2012; 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.