Active NPI
Denise Marie Powell, PT
- Physical Therapist
- Roswell, GA
National Provider Identifier
1154523678
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT007668
- 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
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 | 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 282006299D | Medicaid | GA | |
| 898718498A | Medicaid | GA |
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.