Individual provider Active NPI

Elizabeth Selman Rudd

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1174078604
Registry record updated Nov 6, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT012593 Issued in GA
Practice address
4651 Roswell Rd Ste B103
Atlanta, GA 30342-3054
Phone
(404) 731-7339
NPI assigned
Aug 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2025

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 PT012593 GA Primary

Addresses

Primary practice location

4651 Roswell Rd Ste B103
Atlanta, GA 30342-3054

Mailing address

4651 Roswell Rd Ste B103
Atlanta, GA 30342-3054
Phone (678) 403-3632

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161118000554 GA Practitioner - Physical Therapist in Private Practice 7810276698 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2016
Medicare assignment
May accept Medicare assignment
Group practices
Well EquiptGroup PAC ID 9830430826, 4 clinicians

Practice addresses (Care Compare)

4651 Roswell Rd
Atlanta, GA 30342-3048
Phone (678) 631-7925

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT012593GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Well Equipt CurrentSince Feb 23, 2018 Accepting new patients

Locations

4651 Roswell Rd
Ste B103
Sandy Springs, GA 30342
Phone (404) 254-5905

Organizations & group practices 1

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": "1472083200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1762387200000",
    "number": "1174078604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4651 ROSWELL RD STE B103",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303423054",
            "telephone_number": "678-403-3632"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4651 ROSWELL RD STE B103",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303423054",
            "telephone_number": "404-731-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUDD",
        "first_name": "ELIZABETH",
        "middle_name": "SELMAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-25",
        "last_updated": "2025-11-06",
        "certification_date": "2025-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.