Individual provider Active NPI

Yvette Danielle Fitzgerald, PT

  • Physical Therapist
  • Tucker, GA
National Provider Identifier
1306463807
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT014721 Issued in GA
Practice address
1459 Montreal Rd
Tucker, GA 30084-6900
Phone
(404) 251-3420
Fax
(404) 251-3439
NPI assigned
Jun 30, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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 PT014721 GA Primary

Addresses

Primary practice location

1459 Montreal Rd
Tucker, GA 30084-6900

Mailing address

8259 Wicker Ave
Saint John, IN 46373-8878
Phone (800) 341-1703

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200720003607 GA Practitioner - Physical Therapist in Private Practice 3870917180 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Emory University School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Emory Physical Therapy, LLCGroup PAC ID 1153382676, 96 clinicians

Practice addresses (Care Compare)

1459 Montreal Rd
Suite 304
Tucker, GA 30084-6920
Phone (404) 251-3420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Physical Therapy, LLC Current Accepting new patients
Emory Physical Therapy, LLC CurrentSince Jun 22, 2020 Accepting new patients
Emory Physical Therapy, LLC CurrentSince Jun 22, 2020 Accepting new patients
Emory Physical Therapy, LLC PastSince Oct 6, 2024 Accepting new patients

Locations

1968 Hawks Ln NE
Brookhaven, GA 30329
Phone (404) 251-2537

1845 Satellite Blvd
Ste 600
Duluth, GA 30097
Phone (404) 778-6490

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

1459 Montreal Rd
Ste 304
Tucker, GA 30084
Phone (404) 251-3420

1459 Montreal Rd
Tucker, GA 30084
Phone (404) 251-3420

8259 Wicker Ave
Saint John, IN 46373
Phone (219) 365-6560

Organizations & group practices 4

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": "1593475200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1306463807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8259 WICKER AVE",
            "city": "SAINT JOHN",
            "state": "IN",
            "postal_code": "463738878",
            "telephone_number": "800-341-1703",
            "fax_number": "877-719-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1459 MONTREAL RD",
            "city": "TUCKER",
            "state": "GA",
            "postal_code": "300846900",
            "telephone_number": "404-251-3420",
            "fax_number": "404-251-3439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FITZGERALD",
        "first_name": "YVETTE",
        "middle_name": "DANIELLE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-30",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014721",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tucker, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2020; 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.