Active NPI
Lisa Gabrielson, PT
- Physical Therapist
- Grayson, GA
National Provider Identifier
1447874243
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT004025
- Practice address
- 20 Grayson New Hope Rd Ste C
Grayson, GA 30017-4316 - Phone
- (770) 682-3854
- NPI assigned
- Jun 8, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT004025 | GA | Primary |
Addresses
Primary practice location
20 Grayson New Hope Rd Ste C
Grayson, GA 30017-4316
Mailing address
4421 Fallowfield LN SW
Lilburn, GA 30047-7403
Phone (770) 979-4926
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT004025 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Promotion Physical Therapy Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Specialist
- Loganville, GA
- NPI 1386659894
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1591574400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1591574400000",
"number": "1447874243",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4421 FALLOWFIELD LN SW",
"city": "LILBURN",
"state": "GA",
"postal_code": "300477403",
"telephone_number": "770-979-4926"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 GRAYSON NEW HOPE RD STE C",
"city": "GRAYSON",
"state": "GA",
"postal_code": "300174316",
"telephone_number": "770-682-3854"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GABRIELSON",
"first_name": "LISA",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-06-08",
"last_updated": "2020-06-08",
"certification_date": "2020-06-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT004025",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grayson, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.