Individual provider Active NPI

Kathryn Pender Nabulsi, PT

  • Physical Therapist
  • Alpharetta, GA
National Provider Identifier
1215434105
Registry record updated Apr 9, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
008090 Issued in GA
Practice address
3330 Preston Ridge Rd Ste 240
Alpharetta, GA 30005-4540
Phone
(404) 388-3869
NPI assigned
Apr 9, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 9, 2018

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 008090 GA Primary

Addresses

Primary practice location

3330 Preston Ridge Rd Ste 240
Alpharetta, GA 30005-4540

Mailing address

3081 Jefferson St
Atlanta, GA 30341-3225
Phone (404) 388-3869

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181012002174 GA Practitioner - Physical Therapist in Private Practice 4183976582 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Therapy LLCGroup PAC ID 1153317300, 48 clinicians

Practice addresses (Care Compare)

5580 Roswell Rd
Sandy Springs, GA 30342-1861
Phone (404) 351-5307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Integrated Therapy LLC Physical Therapist CurrentSince Aug 5, 2021 Accepting new patients
Life Clinic of Ga PC Physical Therapist CurrentSince Mar 12, 2022 Accepting new patients
Hcenti, LLC Past Accepting new patients
ENT of Georgia, LLC Past Accepting new patients

Locations

855 North Point Pkwy
Alpharetta, GA 30005
Phone (952) 401-2336

2221 Peachtree Rd NE
Ste D336
Atlanta, GA 30309

2655 Cobb Pkwy NW
Ste 102
Kennesaw, GA 30152

5600 Roswell Rd
Bldg I
Sandy Springs, GA 30342
Phone (404) 303-2323

Organizations & group practices 4

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": "1523232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1523232000000",
    "number": "1215434105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3081 JEFFERSON ST",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303413225",
            "telephone_number": "404-388-3869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3330 PRESTON RIDGE RD STE 240",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300054540",
            "telephone_number": "404-388-3869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NABULSI",
        "first_name": "KATHRYN",
        "middle_name": "PENDER",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-04-09",
        "last_updated": "2018-04-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "008090",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Alpharetta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 9, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.