Individual provider Active NPI

Andrea McMahan

  • Physical Therapist
  • Sandy Springs, GA
National Provider Identifier
1417447459
Registry record updated Aug 17, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT0037307 Issued in GA
Practice address
25 Glenlake Pkwy
Sandy Springs, GA 30328-3403
Phone
(470) 532-8056
Fax
(317) 884-3388
NPI assigned
May 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2018

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 PT0037307 GA Primary

Addresses

Primary practice location

25 Glenlake Pkwy
Sandy Springs, GA 30328-3403

Mailing address

9701 Wesleyan Rd
Suite 100
Indianapolis, IN 46268
Phone (800) 603-6046

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180820000917 GA Practitioner - Physical Therapist in Private Practice 4880942374 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians
Your Aging Therapist LLCGroup PAC ID 6709285992, 8 clinicians

Practice addresses (Care Compare)

255 Vaughn Dr
Alpharetta, GA 30009-2415
Phone (770) 521-9707

3712 Executive Ctr Dr
Suite a
Martinez, GA 30907-5098
Phone (706) 252-3332

3725 Wheeler Rd
Augusta, GA 30909-6623
Phone (706) 364-3325

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT0037307GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Your Aging Therapist LLC Physical Therapist CurrentSince Jun 5, 2023 Accepting new patients
Legacy Healthcare Services Inc Physical Therapist CurrentSince Sep 25, 2023 Accepting new patients
Legacy Healthcare Services, Inc. Physical Therapist CurrentSince Sep 25, 2023 Accepting new patients
Legacy Healthcare Services, Inc. Physical Therapist CurrentSince Sep 25, 2023 Accepting new patients

Locations

3333 E Cherokee Dr
Canton, GA 30115
Phone (470) 714-6698

100 Washington Commons Dr
Evans, GA 30809
Phone (706) 426-8136

3712 Executive Center Dr
Ste A
Martinez, GA 30907
Phone (706) 252-3332

110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300

Organizations & group practices 4

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": "1526342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534464000000",
    "number": "1417447459",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9701 WESLEYAN RD",
            "address_2": "SUITE 100",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46268",
            "telephone_number": "800-603-6046",
            "fax_number": "317-884-3388"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 GLENLAKE PKWY",
            "city": "SANDY SPRINGS",
            "state": "GA",
            "postal_code": "303283403",
            "telephone_number": "470-532-8056",
            "fax_number": "317-884-3388"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCMAHAN",
        "first_name": "ANDREA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-15",
        "last_updated": "2018-08-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT0037307",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy Springs, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2018; 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.