Madison Shreve

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT015853 Issued in GA

Practice address

205 Town Blvd NE Ste 550
Brookhaven, GA 30319-3292

Phone

(404) 869-1912

NPI assigned

Jan 12, 2022

Sex

Female

Sole proprietor

No

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

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Independent Physical Therapy of Georgia, LLCGroup PAC ID 2961312244, 526 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Independent Physical Therapy of Georgia, LLC

  dba BenchMark Physical Therapy

  • Physical Therapist
  • Fort Oglethorpe, GA
  • NPI 1780636068
  Medicare reassignment Care Compare group NPD
• Benchmark Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Duluth, GA
  • NPI 1083666903
  Medicare reassignment NPD
• Drayer Physical Therapy Georgia LLC

  • Physical Therapist
  • Loganville, GA
  • NPI 1962830406
  Medicare reassignment NPD
• Benchmark Physical Therapy Inc

  • Physical Therapist
  • Riverdale, GA
  • NPI 1427000777
  NPD
• Independent Physical Therapy of Georgia, LLC

  dba Benchmark PT

  • Occupational Therapist
  • Gainesville, GA
  • NPI 1306013941

  Physical Therapist

  NPD
• Forsyth Psychiatric Associates, PLLC

  • Psychiatry Physician
  • Clemmons, NC
  • NPI 1326575994
  NPD (past)

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

{
    "created_epoch": "1641945600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652400000000",
    "number": "1437800422",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374212564"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 TOWN BLVD NE STE 550",
            "city": "BROOKHAVEN",
            "state": "GA",
            "postal_code": "303193292",
            "telephone_number": "404-869-1912"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2255 Peachtree Rd NE Ste G",
            "address_purpose": "LOCATION",
            "city": "Atlanta",
            "state": "GA",
            "postal_code": "303091176",
            "country_code": "US",
            "telephone_number": "404-351-3257",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHREVE",
        "first_name": "MADISON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-12",
        "last_updated": "2022-05-13",
        "certification_date": "2022-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT015853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sariah Shelton, RBT
• Abigail Grace Shepherd, RBT
• Bradley David Shepherd, MD
• Lauren Shepherd, RBT
• Tristan Shilo
• Leanne Shub
• Tatyana S Sidorova
• Carolyn H. Sigman, MD
• Destiny Simmons, RBT
• Laura Rohnert Simmons, P.T.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2022; 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.