Jessica Grace Pybus – Physical Therapy Assistant

Key facts

NPI: 1174827422
Entity type: Individual (NPI type 1)
Primary specialty: Physical Therapy Assistant 225200000X
License: PTA5564 (AL)
Practice address: 5500 Chamblee Dunwoody Rd Ste 5B
Dunwoody, GA 30338-4162
Phone: (770) 396-3003
NPI assigned: Dec 30, 2010
Sex: Female
Sole proprietor: No

Organizations & group practices 2

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.

Independent Physical Therapy of Georgia, LLC Physical Therapy Clinic/Center · Dunwoody, GA · NPI 1376956003

NPD (past)
Independent Physical Therapy of Georgia, LLC Physical Therapist · Fort Oglethorpe, GA · NPI 1780636068

NPD (past)

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
PTA5564	AL	MD	Physical Therapy Assistant

Practice roles

Organization	Specialty	Status	New patients
Independent Physical Therapy of Georgia, LLC		Past since Sep 25, 2022	Accepting new patients
Independent Physical Therapy of Georgia, LLC		Past since Sep 25, 2022	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Physical Therapy Assistant	225200000X	PTA5564	AL	Yes

Addresses

Primary practice location

5500 Chamblee Dunwoody Rd Ste 5B
Dunwoody, GA 30338-4162

Mailing address

301 Telluride LN
Midland City, AL 36350-7037
Phone (334) 791-9196

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Sep 19, 2022.

{
    "created_epoch": "1293667200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663545600000",
    "number": "1174827422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 TELLURIDE LN",
            "city": "MIDLAND CITY",
            "state": "AL",
            "postal_code": "363507037",
            "telephone_number": "334-791-9196"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 CHAMBLEE DUNWOODY RD STE 5B",
            "city": "DUNWOODY",
            "state": "GA",
            "postal_code": "303384162",
            "telephone_number": "770-396-3003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PYBUS",
        "first_name": "JESSICA",
        "middle_name": "GRACE",
        "credential": "LPTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-12-30",
        "last_updated": "2022-09-19",
        "certification_date": "2022-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "AL",
            "license": "PTA5564",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dunwoody, GA

All providers in Dunwoody, GA · Physical Therapy Assistant in Georgia

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 19, 2022. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.