Individual provider Active NPI

Jeffrey S. Messina, P.T.

  • Physical Therapist
  • Acworth, GA
National Provider Identifier
1164632147
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT002165 Issued in GA
Practice address
4021 Caddie Dr NW
Acworth, GA 30101-3895
Phone
(404) 202-4531
Fax
(770) 529-7956
NPI assigned
May 22, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 PT002165 GA Primary

Addresses

Primary practice location

4021 Caddie Dr NW
Acworth, GA 30101-3895

Mailing address

4021 Caddie Dr NW
Acworth, GA 30101-3895
Phone (404) 202-4531

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT002165GAMDPhysical Therapist
002165GAMDPhysician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1179792000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164632147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4021 CADDIE DR NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301013895",
            "telephone_number": "404-202-4531",
            "fax_number": "770-529-7956"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4021 CADDIE DR NW",
            "city": "ACWORTH",
            "state": "GA",
            "postal_code": "301013895",
            "telephone_number": "404-202-4531",
            "fax_number": "770-529-7956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MESSINA",
        "first_name": "JEFFREY",
        "middle_name": "S.",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT002165",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Acworth, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.