Kelly Haskell Peczka

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

009203 Issued in GA

Practice address

500 Lanier Ave W Ste 702
Fayetteville, GA 30214-7643

Phone

(413) 250-7848

NPI assigned

Oct 2, 2019

Last updated

Oct 2, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Piedmont Orthopedics, LLCGroup PAC ID 4385963172, 191 clinicians

Georgia Luna Care Physical Therapy LLCGroup PAC ID 4082027727, 167 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/327/brand/1/csg/21/fhir/r4

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.

• Georgia Luna Care Physical Therapy LLC

  • Physical Therapist
  • Atlanta, GA
  • NPI 1245826999
  Medicare reassignment Care Compare group NPD
• Piedmont Orthopedics, LLC

  • Orthopaedic Surgery Physician
  • Atlanta, GA
  • NPI 1114317062
  Medicare reassignment Care Compare group NPD
• Emory Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Atlanta, GA
  • NPI 1922018423
  Medicare reassignment NPD
• Orthoatlanta, LLC

  • Orthopaedic Surgery Physician
  • Newnan, GA
  • NPI 1851937114
  Medicare reassignment NPD
• Emory Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Lithonia, GA
  • NPI 1346119831
  NPD
• Emory Physical Therapy, LLC

  • Physical Therapist
  • Tucker, GA
  • NPI 1962795641
  NPD
• Orthoatlanta, LLC

  • Orthopaedic Surgery Physician
  • Evans, GA
  • NPI 1679251920
  NPD
• Orthoatlanta, LLC

  • Orthopaedic Surgery Physician
  • Atlanta, GA
  • NPI 1982618294

  Physical Therapist

  NPD
• Acts

  • Speech-Language Pathologist
  • Fayetteville, GA
  • NPI 1093253395
  NPD (past)

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

{
    "created_epoch": "1569974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1569974400000",
    "number": "1376184101",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 DINGLER RD",
            "city": "MORELAND",
            "state": "GA",
            "postal_code": "302592229",
            "telephone_number": "413-250-7848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LANIER AVE W STE 702",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147643",
            "telephone_number": "413-250-7848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PECZKA",
        "first_name": "KELLY",
        "middle_name": "HASKELL",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-02",
        "last_updated": "2019-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "009203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peachtree Detox LLC
• Peachtree Fayette Women's Specialists
• Peachtree Women's Physical Therapy, Inc
• Gretchen H Peacock, DMFT
• Shereese Nicole Pearsall
• Pediatric Emergency Medicine Associates LLC
• Matthew Pedrotti, DPT
• Kayla Peeples, OT
• David Parker Pendergrast, RPH
• Krystle Penn

• Physical Therapist in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2019; 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.