Individual provider Active NPI

Jian Xu

  • Physical Therapist
  • Stone Mountain, GA
National Provider Identifier
1336967892
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT017364 Issued in GA
Practice address
1227 Rockbridge Rd Ste 212
Stone Mountain, GA 30087-3040
Phone
(770) 925-9210
NPI assigned
Oct 2, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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 PT017364 GA Primary

Addresses

Primary practice location

1227 Rockbridge Rd Ste 212
Stone Mountain, GA 30087-3040

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (866) 518-0283

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250113000901 GA Practitioner - Physical Therapist in Private Practice 5890223317 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Independent Physical Therapy of Georgia, LLCGroup PAC ID 2961312244, 526 clinicians

Practice addresses (Care Compare)

1227 Rockbridge Rd
Suite 212
Stone Mountain, GA 30087-3040
Phone (770) 925-9210

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT017364GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy Inc Physical Therapist CurrentSince Sep 30, 2024 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Sep 30, 2024 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Sep 30, 2024 Accepting new patients
Benchmark Physical Therapy, Inc CurrentSince Sep 30, 2024 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Sep 30, 2024 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Sep 30, 2024 Accepting new patients

Locations

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

2900 Peachtree Rd NW
Ste 208
Atlanta, GA 30305
Phone (678) 365-3588

2865 N Druid Hills Rd NE
#B
Atlanta, GA 30329
Phone (404) 228-3678

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

11720 Medlock Bridge Rd
Ste 550
Johns Creek, GA 30097
Phone (678) 364-7195

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

860 Duluth Hwy
Ste 140
Lawrenceville, GA 30043
Phone (470) 410-1444

5450 Peachtree Pkwy
Ste 1F
Peachtree Corners, GA 30092
Phone (678) 823-6100

10800 Alpharetta Hwy
Ste 176
Roswell, GA 30076
Phone (678) 364-7195

6635 Roswell Rd
Sandy Springs, GA 30328
Phone (678) 332-2030

2059 Scenic Hwy N
Ste C
Snellville, GA 30078
Phone (470) 568-2818

1227 Rockbridge Rd
Ste 212
Stone Mountain, GA 30087
Phone (770) 925-9210

4135 Lavista Rd
Ste 110
Tucker, GA 30084
Phone (470) 568-2622

Organizations & group practices 6

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": "1727827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1336967892",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "866-518-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1227 ROCKBRIDGE RD STE 212",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300873040",
            "telephone_number": "770-925-9210"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "XU",
        "first_name": "JIAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-10-02",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT017364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2024; 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.