Individual provider Active NPI

Alena Koval

  • Physical Therapy Assistant
  • Cumming, GA
National Provider Identifier
1205386679
Registry record updated Oct 10, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy AssistantTaxonomy code 225200000X
License
003630 Issued in GA
Practice address
5235 Double Branches Dr
Cumming, GA 30040-6360
Phone
(770) 789-6767
NPI assigned
Oct 10, 2016
Last updated
Oct 10, 2016By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Assistant 225200000X 003630 GA Primary

Addresses

Primary practice location

5235 Double Branches Dr
Cumming, GA 30040-6360

Mailing address

5235 Double Branches Dr
Cumming, GA 30040-6360
Phone (770) 789-6767

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

NPI Registry JSON

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

{
    "created_epoch": "1476057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1476057600000",
    "number": "1205386679",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5235 DOUBLE BRANCHES DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300406360",
            "telephone_number": "770-789-6767"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5235 DOUBLE BRANCHES DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300406360",
            "telephone_number": "770-789-6767"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOVAL",
        "first_name": "ALENA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-10-10",
        "last_updated": "2016-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "GA",
            "license": "003630",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2016; 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.