Active NPI
Celina Chung, MSPT
- Physical Therapist
- Fort Moore, GA
National Provider Identifier
1457675019
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 019437-1
- Practice address
- 6600 Van Aalst Blvd BLDG 9250
Fort Moore, GA 31905-2102 - Phone
- (706) 545-5560
- NPI assigned
- Mar 24, 2010
- 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 | 019437-1 | NY | Primary |
Addresses
Primary practice location
6600 Van Aalst Blvd BLDG 9250
Fort Moore, GA 31905-2102
Mailing address
6600 Van Aalst Blvd BLDG 9250
Fort Moore, GA 31905-2102
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 019437-1 | Other | NY | PT LICENSE |
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 |
|---|---|---|---|
| 019437-1 | NY | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1269388800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1702425600000",
"number": "1457675019",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6600 VAN AALST BLVD BLDG 9250",
"city": "FORT MOORE",
"state": "GA",
"postal_code": "319052102"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6600 VAN AALST BLVD BLDG 9250",
"city": "FORT MOORE",
"state": "GA",
"postal_code": "319052102",
"telephone_number": "706-545-5560"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHUNG",
"first_name": "CELINA",
"credential": "MSPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-03-24",
"last_updated": "2023-12-13",
"certification_date": "2023-12-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "019437-1",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PT LICENSE",
"identifier": "019437-1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Moore, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 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.