Active NPI
Noel Lukose
- Physical Therapist
- Loganville, GA
National Provider Identifier
1215815154
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 3541 Highway 81
Loganville, GA 30052-4336 - Phone
- (678) 495-2990
- NPI assigned
- Aug 26, 2025
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
3541 Highway 81
Loganville, GA 30052-4336
Mailing address
1111 Windsor Creek Dr
Grayson, GA 30017-4952
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": "1756166400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1756166400000",
"number": "1215815154",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1111 WINDSOR CREEK DR",
"city": "GRAYSON",
"state": "GA",
"postal_code": "300174952"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3541 HIGHWAY 81",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300524336",
"telephone_number": "678-495-2990"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUKOSE",
"first_name": "NOEL",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2025-08-26",
"last_updated": "2025-08-26",
"certification_date": "2025-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Loganville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.