Aubrey Blackstock
Individual provider Active NPI Physical Therapist · Dunwoody, GA
NPI 1326712910 · NPPES record last updated Aug 6, 2021
Key facts
- NPI
- 1326712910
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT015423 (GA)
- Practice address
- 5500 Chamblee Dunwoody Rd Ste E5
Dunwoody, GA 30338-4162 - Phone
- (770) 396-3003
- NPI assigned
- Aug 6, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 12
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2021
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Independent Physical Therapy of Georgia, LLC
Practice addresses (Care Compare)
5500 Chamblee Dunwoody Rd
Suite 5E
Atlanta, GA 30338-4165
Phone (678) 256-3920
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210812003114 | GA | Practitioner - Physical Therapist in Private Practice | 0143624114 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Independent Physical Therapy of Georgia, LLC | Physical Therapist | Current |
Accepting new patients |
| Independent Physical Therapy of Georgia, LLC | Physical Therapist | Current |
Accepting new patients |
| Independent Physical Therapy of Georgia, LLC | Past | 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
5500 Chamblee Dunwoody Rd
Ste 5B
Dunwoody, GA 30338
Phone (678) 981-6290
5500 Chamblee Dunwoody Rd
Ste 5E
Dunwoody, GA 30338
Phone (678) 256-3920
6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT015423 | GA | Yes |
Addresses
Primary practice location
5500 Chamblee Dunwoody Rd Ste E5
Dunwoody, GA 30338-4162
Mailing address
6397 Lee Hwy Ste 300
Chattanooga, TN 37421-4915
Other providers in Dunwoody, GA
- Deann Bing
- Bizcare Solutions, Inc
- BJT and Associates
- Shaherah Black
- Madeline Elaine Blackadar
- Kathryn Bland
- Blissful Beginnings Counseling
- Twila Blossom Jones
- Kathy Bolia
- Whitney Hendricks Bolle
All providers in Dunwoody, GA · Physical Therapist in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 6, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.