Mary Lacy Lusk, PT, DPT

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

PT017621 Issued in GA

Practice address

3827 Jimmy Lee Smith Pkwy Ste 122
Hiram, GA 30141-2804

Phone

(770) 943-1142

NPI assigned

Mar 3, 2025

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Kennestone Hospital, Inc

  • Psychiatric Hospital Unit
  • Atlanta, GA
  • NPI 1689361438
  NPD (past)
• PT Solutions of Acworth LLC

  • Physical Therapist
  • Augusta, GA
  • NPI 1518435189
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1740960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740960000000",
    "number": "1275330706",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1295 DRESDEN DR NE UNIT 221",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303195858",
            "telephone_number": "662-832-1675"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3827 JIMMY LEE SMITH PKWY STE 122",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301412804",
            "telephone_number": "770-943-1142"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUSK",
        "first_name": "MARY",
        "middle_name": "LACY",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-03-03",
        "last_updated": "2025-03-03",
        "certification_date": "2025-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "GA",
            "license": "PT017621",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamara Dawn Lively, M.A., LPC
• Living Beyond LLC
• Liz Moon LLC
• Chris Dana Lockerman, D.C.
• Kathleen A. Long, MD
• Luxottica Retail North America Inc
• Lynn Family Eyecare PC
• Kristine Lynn, O.D.
• Darian Lyons
• M&M Prime LLC

• Orthopedic Physical Therapist in Hiram, GA
• Providers in Hiram, GA by specialty
• Orthopedic Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 3, 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.

Verify at the official NPI Registry.