Dalton Jansen, PT, DPT, CERT. DN

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT017349 Issued in GA

Practice address

1031 Lake Country Dr
Greensboro, GA 30642-5157

Phone

(706) 549-1663

NPI assigned

Jul 30, 2024

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2024

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Athens Orthopedic Clinic, PAGroup PAC ID 5991600181, 70 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: dalton.jansen.1@28045.direct.athenahealth.com

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.

• Athens Orthopedic Clinic, PA

  • Orthopaedic Surgery Physician
  • Athens, GA
  • NPI 1063495299
  Medicare reassignment Care Compare group NPD
• Athens Orthopedic Clinic, PA

  • Orthopaedic Surgery Physician
  • Greensboro, GA
  • NPI 1104219468
  NPD
• Pediatric Orthopedic Associates

  • Pediatric Radiology Physician
  • Salt Lake City, UT
  • NPI 1659488799
  NPD (past)

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

{
    "created_epoch": "1722297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725321600000",
    "number": "1275362113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1765 OLD WEST BROAD ST BLDG 2-200",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306062887",
            "telephone_number": "706-549-1663",
            "fax_number": "706-546-8792"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1031 LAKE COUNTRY DR",
            "city": "GREENSBORO",
            "state": "GA",
            "postal_code": "306425157",
            "telephone_number": "706-549-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANSEN",
        "first_name": "DALTON",
        "credential": "PT, DPT, CERT. DN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-07-30",
        "last_updated": "2024-09-03",
        "certification_date": "2024-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT017349",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAQH NUMBER",
            "identifier": "16267034",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Independent Physical Therapy of Ga, LLC
• Intuitive Neurodiagnostics LLC
• Isd Renal Inc
• Megan McFaddin Jackson, NP
• Missy Leigh Jackson
• Emily Jefferson
• Jing Dong MD PC
• Caitlyn Cook Johnston, FNP-BC
• Ansley Pike Jones, DMD
• Dominique Jones

• Physical Therapist in Greensboro, GA
• Providers in Greensboro, GA by specialty
• Physical Therapist in Georgia

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