Individual provider Active NPI

Elizabeth Killian, DPT

  • Physical Therapist
  • Kennesaw, GA
National Provider Identifier
1235337205
Registry record updated Mar 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8891 Issued in GA
Practice address
3450 Acworth Due West Rd NW
BLDG. 300, Suite 310
Kennesaw, GA 30144-1001
Phone
(770) 974-7494
Fax
(770) 974-9141
NPI assigned
Jul 10, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 11, 2008

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 8891 GA Primary

Addresses

Primary practice location

3450 Acworth Due West Rd NW
BLDG. 300, Suite 310
Kennesaw, GA 30144-1001

Mailing address

410 Candler Park Dr NE
Unit E1
Atlanta, GA 30307-2142
Phone (404) 433-5825

Other identifiers 1

IdentifierTypeStateIssuer
393730OtherGABLUE CROSS BLUE SHIELD

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070919000289 GA Practitioner - Physical Therapist in Private Practice 7618061805 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8891GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Physical Therapy, LLC CurrentSince Jun 23, 2024 Accepting new patients
Emory Physical Therapy, LLC Current Accepting new patients
Emory Physical Therapy, LLC CurrentSince Jun 23, 2024 Accepting new patients

Locations

21 Ortho Ln
Atlanta, GA 30329
Phone (404) 778-2516

1845 Satellite Blvd
Ste 750
Duluth, GA 30097
Phone (404) 778-6490

Organizations & group practices 3

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": "1184025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1205193600000",
    "number": "1235337205",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CANDLER PARK DR NE",
            "address_2": "UNIT E1",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303072142",
            "telephone_number": "404-433-5825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3450 ACWORTH DUE WEST RD NW",
            "address_2": "BLDG. 300, SUITE 310",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301441001",
            "telephone_number": "770-974-7494",
            "fax_number": "770-974-9141"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILLIAN",
        "first_name": "ELIZABETH",
        "name_prefix": "Dr.",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-07-10",
        "last_updated": "2008-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "8891",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "393730",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.