Individual provider Active NPI

Janette Virginia Piedra, PT, DPT

  • Physical Therapist
  • Cleveland, GA
National Provider Identifier
1205513157
Registry record updated Dec 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT017488 Issued in GA
Practice address
1706 Highway 129 S Ste B
Cleveland, GA 30528-4945
Phone
(706) 219-4507
NPI assigned
Jul 3, 2023
Last updated
Dec 11, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 11, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT5761 NM
Physical Therapist 225100000X PT004701 WV
Physical Therapist 225100000X PT017488 GA Primary

Addresses

Primary practice location

1706 Highway 129 S Ste B
Cleveland, GA 30528-4945

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Other practice location 1

1055 Alta Vista Dr
Chaparral, NM 88081-7381
Phone (575) 201-8875

Other identifiers 2

IdentifierTypeStateIssuer
PT004701OtherWVWEST VIRGINIA BOARD OF PHYSICAL THERAPY
PT5761OtherNMSTATE OF NEW MEXICO PHYSICAL THERAPY BOARD

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT017488GAMDPhysical Therapist
PT5761NMMDPhysical Therapist
PT004701WVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy, Inc CurrentSince Dec 11, 2024 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Dec 11, 2024 Accepting new patients
Benchmark Physical Therapy Inc Physical Therapist CurrentSince Dec 11, 2024 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Dec 11, 2024 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Dec 11, 2024 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Dec 11, 2024 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

1706 Highway 129 S
#B
Cleveland, GA 30528
Phone (706) 219-4507

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1688342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733875200000",
    "number": "1205513157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1706 HIGHWAY 129 S STE B",
            "city": "CLEVELAND",
            "state": "GA",
            "postal_code": "305284945",
            "telephone_number": "706-219-4507"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1055 Alta Vista Dr",
            "address_purpose": "LOCATION",
            "city": "Chaparral",
            "state": "NM",
            "postal_code": "880817381",
            "country_code": "US",
            "telephone_number": "575-201-8875",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PIEDRA",
        "first_name": "JANETTE",
        "middle_name": "VIRGINIA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-07-03",
        "last_updated": "2024-12-11",
        "certification_date": "2024-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NM",
            "license": "PT5761",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "WV",
            "license": "PT004701",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT017488",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WEST VIRGINIA BOARD OF PHYSICAL THERAPY",
            "identifier": "PT004701",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE OF NEW MEXICO PHYSICAL THERAPY BOARD",
            "identifier": "PT5761",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2024; 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.