Individual provider Active NPI

Gunnar Mendiola

  • Physical Therapist
  • Kennesaw, GA
National Provider Identifier
1285100321
Registry record updated Oct 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
3150 N Cobb Pkwy Ste 150
Kennesaw, GA 30152-1009
Phone
(678) 574-6868
NPI assigned
Oct 16, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 16, 2018

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

3150 N Cobb Pkwy Ste 150
Kennesaw, GA 30152-1009

Mailing address

4258 Shipyard Trce NE
Roswell, GA 30075-5254
Phone (478) 960-7376

Other practice location 1

655 Molly Ln Ste 100
Woodstock, GA 30189-6519
Phone (770) 517-1080

Other practice location 2

695 Henderson Dr
Cartersville, GA 30120-3738
Phone (770) 386-6300

Other practice location 3

2155 Post Oak Tritt Rd Ste 400
Marietta, GA 30062-1651
Phone (770) 565-4044

Other practice location 4

24 E Crossville Rd Ste 150
Roswell, GA 30075-7684
Phone (678) 822-0721

Other practice location 5

390 Ernest W Barrett Pkwy NW Ste 4
Kennesaw, GA 30144-4989
Phone (770) 426-9945

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Total Therapy Services Physical Therapist PastSince Jul 25, 2019 Accepting new patients
Remedy Behavioral Health, LLC PastSince Jan 15, 2020 Accepting new patients

Organizations & group practices 2

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": "1539648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539648000000",
    "number": "1285100321",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4258 SHIPYARD TRCE NE",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300755254",
            "telephone_number": "478-960-7376"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3150 N COBB PKWY STE 150",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301521009",
            "telephone_number": "678-574-6868"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "655 Molly Ln Ste 100",
            "address_purpose": "LOCATION",
            "city": "Woodstock",
            "state": "GA",
            "postal_code": "301896519",
            "country_code": "US",
            "telephone_number": "770-517-1080",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "695 Henderson Dr",
            "address_purpose": "LOCATION",
            "city": "Cartersville",
            "state": "GA",
            "postal_code": "301203738",
            "country_code": "US",
            "telephone_number": "770-386-6300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2155 Post Oak Tritt Rd Ste 400",
            "address_purpose": "LOCATION",
            "city": "Marietta",
            "state": "GA",
            "postal_code": "300621651",
            "country_code": "US",
            "telephone_number": "770-565-4044",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "24 E Crossville Rd Ste 150",
            "address_purpose": "LOCATION",
            "city": "Roswell",
            "state": "GA",
            "postal_code": "300757684",
            "country_code": "US",
            "telephone_number": "678-822-0721",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "390 Ernest W Barrett Pkwy NW Ste 4",
            "address_purpose": "LOCATION",
            "city": "Kennesaw",
            "state": "GA",
            "postal_code": "301444989",
            "country_code": "US",
            "telephone_number": "770-426-9945",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MENDIOLA",
        "first_name": "GUNNAR",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-16",
        "last_updated": "2018-10-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 16, 2018; 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.