Alyson Kimbrell Repko, DPT
Individual provider Active NPI Physical Therapist · Johns Creek, GA
NPI 1194124891 · NPPES record last updated Sep 7, 2016
Key facts
- NPI
- 1194124891
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT011108 (GA)
- Practice address
- 5690 State Bridge Rd
Johns Creek, GA 30022-6002 - Phone
- (678) 395-4202
- Fax
- (678) 395-4725
- NPI assigned
- Aug 19, 2014
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 6
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Emory University School of Medicine, 2013
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Coastal Voice and Dysphagia Diagnostics, LLC
Practice addresses (Care Compare)
24 S Zetterower Ave
Statesboro, GA 30458-4866
Phone (912) 687-1026
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20141231000299 | GA | Practitioner - Physical Therapist in Private Practice | 3173846938 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aegis Group Practice LLC | Physical Therapist | Current |
Accepting new patients |
| Aegis Group Practice LLC | Physical Therapist | Current | Accepting new patients |
| Coastal Voice & Dysphagia Diagnostics, LLC | Current |
Accepting new patients | |
| Aegis Group Practice LLC | Physical Therapist | Current |
Accepting new patients |
| Ability Pro Therapy, LLC | Physical Therapist | Past |
Accepting new patients |
Locations
4933 Old Greenwood Rd
Fort Smith, AR 72903
5690 State Bridge Rd
Johns Creek, GA 30022
Phone (678) 395-4202
5690 State Bridge Rd
#9013
Johns Creek, GA 30022
Phone (770) 591-6583
24 S Zetterower Ave
Statesboro, GA 30458
Phone (912) 299-2394
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT011108 | GA | Yes |
Addresses
Primary practice location
5690 State Bridge Rd
Johns Creek, GA 30022-6002
Mailing address
5690 State Bridge Rd
Johns Creek, GA 30022-6002
Phone (678) 395-4202
Other names
- Alyson Noel Kimbrell
Other providers in Johns Creek, GA
- Diana Reeves
- Natalie Moore Reisman
- James Ren
- Larry J Render
- Renew Health and Physical Medicine
- Natalie Cindy Reto
- Ingrid Vivian Reyes
- John C Reyes
- Mark Andrew Reyka
- Steve Ricci
All providers in Johns Creek, GA · Physical Therapist 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 7, 2016. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.