Individual provider Active NPI

Allyson McDaniel, PT, DPT

  • Physical Therapist
  • Lilburn, GA
National Provider Identifier
1306584248
Registry record updated May 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT015884 Issued in GA
Practice address
4024 Lawrenceville Hwy NW Ste 19&20
Lilburn, GA 30047-2999
Phone
(770) 931-8686
NPI assigned
May 20, 2022
Last updated
May 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 20, 2022

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 PT015884 GA Primary

Addresses

Primary practice location

4024 Lawrenceville Hwy NW Ste 19&20
Lilburn, GA 30047-2999

Mailing address

5234 White Oak Rd
Appling, GA 30802-2005

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241217002725 GA Practitioner - Physical Therapist in Private Practice 7911434873 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT015884GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Matrix Rehabilitation-Georgia Inc CurrentSince Oct 1, 2024 Accepting new patients
Matrix Rehabilitation-Georgia Inc Past Accepting new patients

Locations

4024 Lawrenceville Hwy NW
Ste 1920
Lilburn, GA 30047
Phone (770) 931-8686

4024 Lawrenceville Hwy NW
Ste 19AND20
Lilburn, GA 30047
Phone (770) 931-8686

234 Jonesboro Rd
McDonough, GA 30253
Phone (770) 954-9631

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1653004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1653004800000",
    "number": "1306584248",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5234 WHITE OAK RD",
            "city": "APPLING",
            "state": "GA",
            "postal_code": "308022005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4024 LAWRENCEVILLE HWY NW STE 19&20",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300472999",
            "telephone_number": "770-931-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCDANIEL",
        "first_name": "ALLYSON",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-20",
        "last_updated": "2022-05-20",
        "certification_date": "2022-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT015884",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lilburn, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.