Pep Physical Therapy, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

PEP PHYSICAL THERAPY, LLC

Practice address

401 Hickory Walk SW
Marietta, GA 30064-3040

Phone

(678) 910-7737

NPI assigned

Sep 18, 2020

Organization subpart

No

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

Authorized official

Name

Lena Ebron, PT,DPTNPI 1508288929

Title

Physical Therapist

Phone

(678) 910-7737

Specialties & licenses 1

Addresses

Other names 1

• PEP Physical Therapy Former legal business name

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lena Danielle Ebron, PT, DPT

  • Physical Therapist
  • Marietta, GA
  • NPI 1508288929
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1600387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600387200000",
    "number": "1376159020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 HICKORY WALK SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300643040",
            "telephone_number": "678-910-7737"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 HICKORY WALK SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300643040",
            "telephone_number": "678-910-7737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEP PHYSICAL THERAPY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-18",
        "last_updated": "2020-09-18",
        "certification_date": "2020-09-18",
        "status": "A",
        "authorized_official_last_name": "EBRON",
        "authorized_official_first_name": "LENA",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "678-910-7737",
        "authorized_official_credential": "PT,DPT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "lena@lenaebronpt.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "address_1": "401 Hickory Walk SW",
            "city": "Marietta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300643040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "PEP Physical Therapy",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Joseph Scott Pennington, LPC
• Scott David Pennington, D.O.
• Matthew Penoyar, LMT
• Katherine Penuela
• Nicole Peoples, DO
• Marlene Kit-Blue Pepukayi, NP
• Kent Hereford Percy, DDS
• Laura Beth Perelman, DPT
• Sasha Perez-Garreaud
• Adacelis Perez

• Physical Therapy Clinic/Center in Marietta, GA
• Providers in Marietta, GA by specialty
• Physical Therapy Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2020; 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.