Daniela Juarez, PTA

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

PTA004894 Issued in GA

Practice address

1541 Old Buckhead Rd
Madison, GA 30650-4256

Phone

(706) 342-0336

Fax

(706) 342-0337

NPI assigned

Apr 6, 2023

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• East Athens Physical Therapy Inc

  • Physical Therapy Clinic/Center
  • Athens, GA
  • NPI 1326082611
  NPD

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

{
    "created_epoch": "1680739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680739200000",
    "number": "1306531397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "665 GAINES SCHOOL RD",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306053127",
            "telephone_number": "706-369-8115",
            "fax_number": "706-369-8116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1541 OLD BUCKHEAD RD",
            "city": "MADISON",
            "state": "GA",
            "postal_code": "306504256",
            "telephone_number": "706-342-0336",
            "fax_number": "706-342-0337"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "665 Gaines School Rd",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306053127",
            "country_code": "US",
            "telephone_number": "706-369-8115",
            "fax_number": "706-369-8116",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "JUAREZ",
        "first_name": "DANIELA",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-06",
        "last_updated": "2023-04-06",
        "certification_date": "2023-04-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "PTA004894",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "djuarez@eastathenspt.com",
            "affiliation": "N",
            "address_1": "665 Gaines School Rd",
            "city": "Athens",
            "state": "GA",
            "country_code": "US",
            "postal_code": "306053127",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ingles Markets Inc.
• Charles Thomas Ingram Jr., MD
• Hannah Emily Johnson, M.ED.
• Jeffrey Johnson, CSFA
• John D Joiner
• Pamela Clardy Key
• Kids Time Pediatrics - Alpharetta, LLC
• Kids Time Pediatrics - East Cobb LLC
• Kids Time Pediatrics - East Cobb, LLC
• Kids Time Pediatrics, LLC

• All providers in Madison, GA
• Physical Medicine & Rehabilitation Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2023; 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.