Foster Deariso, PT, DPT, ATC, LAT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT016487 Issued in GA

Practice address

1955 Nocturne Dr Unit 3410
Alpharetta, GA 30009-4830

Phone

(478) 696-2483

NPI assigned

Aug 27, 2015

Last updated

Mar 13, 2023By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Gcsu Athletic Training

  • Athletic Trainer
  • Milledgeville, GA
  • NPI 1033111638
  NPD (past)

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

{
    "created_epoch": "1440633600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1427425230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1955 NOCTURNE DR UNIT 3410",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300094830",
            "telephone_number": "478-696-2483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1955 NOCTURNE DR UNIT 3410",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300094830",
            "telephone_number": "478-696-2483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEARISO",
        "first_name": "FOSTER",
        "credential": "PT, DPT, ATC, LAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-27",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT002784",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT016487",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kelly Marie Day, M.D.
• DC Therapeutic Interventions, LLC
• Gabriela De Souza Costa
• Ja'Monica Dean
• Deanna R. Grim, Ed.D., Inc.
• Olivia Dedels, M.ED., NCC
• Natasha Dedijer-Turner
• Whitney Louise Deedy
• Ellen Degnan, RN, CPNP
• Manuel Del Valle

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.