Active NPI
Deandrea Jefferson
- Physical Therapy Assistant
- Savannah, GA
National Provider Identifier
1477933729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapy Assistant
- License
- PTA003450
- Practice address
- 1 Peachtree Dr
Savannah, GA 31419-1200 - Phone
- (912) 927-0500
- NPI assigned
- Jun 2, 2015
- 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 Therapy Assistant | 225200000X | PTA003450 | GA | Primary |
Addresses
Primary practice location
1 Peachtree Dr
Savannah, GA 31419-1200
Mailing address
45 Chestnut Oak Dr
Richmond Hill, GA 31324-5679
Phone (803) 237-6672
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 |
|---|---|---|---|
| PTA003450 | GA | MD | Physical Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1433203200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1477933729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "45 CHESTNUT OAK DR",
"city": "RICHMOND HILL",
"state": "GA",
"postal_code": "313245679",
"telephone_number": "803-237-6672"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1 PEACHTREE DR",
"city": "SAVANNAH",
"state": "GA",
"postal_code": "314191200",
"telephone_number": "912-927-0500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JEFFERSON",
"first_name": "DEANDREA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-02",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "225200000X",
"taxonomy_group": "",
"desc": "Physical Therapy Assistant",
"state": "GA",
"license": "PTA003450",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Savannah, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.