Active NPI
Shyrece Celestine
- Physical Therapist
- Roswell, GA
National Provider Identifier
1487364428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT016137
- Practice address
- 75 Magnolia St
Roswell, GA 30075-4381 - Phone
- (337) 274-6953
- NPI assigned
- Nov 30, 2022
- 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 | PT016137 | GA | Primary |
Addresses
Primary practice location
75 Magnolia St
Roswell, GA 30075-4381
Mailing address
3631 Chamblee Tucker Rd Unit 941084
Atlanta, GA 31141-5005
Phone (337) 274-6953
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT016137 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Legacy Healthcare Services, Inc. | Physical Therapist | Current | Accepting new patients |
| Legacy Healthcare Services, Inc. | Physical Therapist | Current | Accepting new patients |
| Legacy Healthcare Services Inc | Physical Therapist | Current | Accepting new patients |
Locations
3333 E Cherokee Dr
Canton, GA 30115
Phone (470) 714-6698
110 Horizon Dr
Ste 310
Raleigh, NC 27615
Phone (970) 215-3300
Organizations & group practices 3
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.
-
- Physical Therapist
- Dawsonville, GA
- NPI 1528419751
-
- Physical Therapist
- Winder, GA
- NPI 1831619337
-
- Physical Therapist
- Cary, NC
- NPI 1225879489
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1669766400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1669766400000",
"number": "1487364428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3631 CHAMBLEE TUCKER RD UNIT 941084",
"city": "ATLANTA",
"state": "GA",
"postal_code": "311415005",
"telephone_number": "337-274-6953"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "75 MAGNOLIA ST",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300754381",
"telephone_number": "337-274-6953"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CELESTINE",
"first_name": "SHYRECE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-11-30",
"last_updated": "2022-11-30",
"certification_date": "2022-11-30",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT016137",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Roswell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 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.