Individual provider Active NPI

Jessica Ann Giles, RPT

  • Physical Therapist
  • Cumming, GA
National Provider Identifier
1205904273
Registry record updated Jan 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT006695 Issued in GA
Practice address
1565 Mountclaire Dr
Cumming, GA 30041-9525
Phone
(678) 513-7434
Fax
(678) 513-2192
NPI assigned
Nov 30, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 19, 2022

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 PT006695 GA Primary

Addresses

Primary practice location

1565 Mountclaire Dr
Cumming, GA 30041-9525

Mailing address

1565 Mountclaire Dr
Cumming, GA 30041-9525
Phone (678) 513-7434

Other identifiers 1

IdentifierTypeStateIssuer
000859053EMedicaidGA

Other names 1

  • Jessica Ann Jenn Former name

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

State licenses

LicenseStateTypeSpecialty
PT006695GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Giles Pediatric Therapy Services, Inc. Physical Therapist Past Accepting new patients

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": "1164844800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642550400000",
    "number": "1205904273",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1565 MOUNTCLAIRE DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300419525",
            "telephone_number": "678-513-7434",
            "fax_number": "678-513-2192"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1565 MOUNTCLAIRE DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300419525",
            "telephone_number": "678-513-7434",
            "fax_number": "678-513-2192"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GILES",
        "first_name": "JESSICA",
        "middle_name": "ANN",
        "credential": "RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-30",
        "last_updated": "2022-01-19",
        "certification_date": "2022-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT006695",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000859053E",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "JENN",
            "middle_name": "ANN",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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 Jan 19, 2022; 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.