Peter Cicinelli

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

012818 Issued in GA

Practice address

11660 Alpharetta Hwy Ste 305
Roswell, GA 30076-3877

Phone

(470) 715-0571

NPI assigned

May 20, 2015

Reactivated

Jun 3, 2022

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Ascend Physical Therapy LLC

  • Physical Therapy Clinic/Center
  • Roswell, GA
  • NPI 1730825365
  NPD Authorized official

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

{
    "created_epoch": "1432080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758931200000",
    "number": "1164801387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11660 ALPHARETTA HWY STE 305",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300763877",
            "telephone_number": "470-715-0571"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11660 ALPHARETTA HWY STE 305",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300763877",
            "telephone_number": "470-715-0571"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICINELLI",
        "first_name": "PETER",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-05-20",
        "last_updated": "2025-09-27",
        "certification_date": "2025-09-27",
        "deactivation_date": "2022-05-06",
        "reactivation_date": "2022-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "012818",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0013255",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DORA",
            "identifier": "0013255",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Courtney D. Christmas
• Olivia Christner
• Christopher Chu
• Uni Chung
• Lauren Cicinelli, RD
• George Bennett Cierny, M.D
• Circulatory Centers Georgia, P.C.
• April S Clark, MS, LAT, ATC
• Elizabeth Clark
• Gabriela Clark, FNP-C

• Physical Therapist in Roswell, GA
• Providers in Roswell, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2025; 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.