Individual provider Active NPI

Ryan Daniel Ahlenius

  • Orthopedic Physical Therapist
  • Loganville, GA
National Provider Identifier
1356810113
Registry record updated Nov 21, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT013779 Issued in GA
Practice address
6360 Dove Dr
Loganville, GA 30052-3031
Phone
(404) 683-9523
NPI assigned
Nov 21, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2018

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT013779 GA Primary

Addresses

Primary practice location

6360 Dove Dr
Loganville, GA 30052-3031

Mailing address

6360 Dove Dr
Loganville, GA 30052-3031

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241221000000 GA Practitioner - Physical Therapist in Private Practice 8628505195 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Physiotherapy Associates Inc CurrentSince Oct 1, 2024 Accepting new patients
Physiotherapy Associates Inc CurrentSince Oct 1, 2024 Accepting new patients

Locations

966A Killian Hill Rd SW
Lilburn, GA 30047
Phone (770) 923-4815

2155 Post Oak Tritt Rd
Ste 400
Marietta, GA 30062
Phone (770) 565-4044

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1542758400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1542758400000",
    "number": "1356810113",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6360 DOVE DR",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300523031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6360 DOVE DR",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300523031",
            "telephone_number": "404-683-9523"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AHLENIUS",
        "first_name": "RYAN",
        "middle_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-11-21",
        "last_updated": "2018-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "GA",
            "license": "PT013779",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Loganville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2018; 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.