Individual provider Active NPI

Erika Lea Fajman, PT, DPT

  • Physical Therapist
  • Riverdale, GA
National Provider Identifier
1285189506
Registry record updated Aug 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT012548 Issued in GA
Practice address
155 Medical Way
Ste a
Riverdale, GA 30274-4940
Phone
(770) 991-2747
Fax
(770) 991-1704
NPI assigned
Aug 16, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2016

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 PT012548 GA Primary

Addresses

Primary practice location

155 Medical Way
Ste a
Riverdale, GA 30274-4940

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160825002881 GA Practitioner - Physical Therapist in Private Practice 2860787082 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Emory University School of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1025 E W Connector
Suite 406
Austell, GA 30106-8531
Phone (770) 384-1001

2300 Bethelview Rd
Suite 203
Cumming, GA 30040-9475
Phone (770) 888-1106

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT012548GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Aug 22, 2016 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Aug 22, 2016 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

2300 Bethelview Rd
Ste 203
Cumming, GA 30040
Phone (770) 888-1106

600 Chastain Rd NW
Ste 428
Kennesaw, GA 30144
Phone (770) 425-6701

11490 Alpharetta Hwy
Ste 200
Roswell, GA 30076
Phone (770) 740-8592

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

8823 Production Ln
Ooltewah, TN 37363
Phone (423) 238-8923

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": "1471305600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1471305600000",
    "number": "1285189506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-362-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "155 MEDICAL WAY",
            "address_2": "STE A",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302744940",
            "telephone_number": "770-991-2747",
            "fax_number": "770-991-1704"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAJMAN",
        "first_name": "ERIKA",
        "middle_name": "LEA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-16",
        "last_updated": "2016-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverdale, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2016; 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.