Individual provider Active NPI

Ese Ataga, DPT

  • Physical Therapist
  • Fayetteville, GA
National Provider Identifier
1215763503
Registry record updated Sep 12, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
290 Highway 314 Ste B
Fayetteville, GA 30214-7813
Phone
(404) 994-7727
Fax
(404) 994-7728
NPI assigned
Sep 12, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 12, 2024

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 Primary

Addresses

Primary practice location

290 Highway 314 Ste B
Fayetteville, GA 30214-7813

Mailing address

290 Highway 314 Ste B
Fayetteville, GA 30214-7813
Phone (404) 994-7727

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241125002310 GA Practitioner - Physical Therapist in Private Practice 2668907841 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ideal Therapy, LLCGroup PAC ID 6002963642, 2 clinicians

Practice addresses (Care Compare)

290 Hwy 314
Suite B
Fayetteville, GA 30214-7813
Phone (404) 994-7727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ideal Therapy, LLC Physical Therapist CurrentSince Oct 3, 2024 Accepting new patients

Locations

290 Highway 314
Ste B
Fayetteville, GA 30214
Phone (404) 994-7727

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": "1726099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726099200000",
    "number": "1215763503",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 HIGHWAY 314 STE B",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147813",
            "telephone_number": "404-994-7727",
            "fax_number": "404-994-7728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "290 HIGHWAY 314 STE B",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147813",
            "telephone_number": "404-994-7727",
            "fax_number": "404-994-7728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ATAGA",
        "first_name": "ESE",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-12",
        "last_updated": "2024-09-12",
        "certification_date": "2024-09-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2024; 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.