Individual provider Active NPI

Stephanie Wong Ewing, PT, DPT

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1497088710
Registry record updated Feb 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT009754 Issued in GA
Practice address
3597 Keswick Dr
Atlanta, GA 30341-2003
Phone
(678) 313-3872
NPI assigned
Sep 18, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT009754 GA Primary

Addresses

Primary practice location

3597 Keswick Dr
Atlanta, GA 30341-2003

Mailing address

3597 Keswick Dr
Atlanta, GA 30341-2003

Other practice location 1

11940 Alpharetta Hwy
Suite 150
Alpharetta, GA 30009-2003
Phone (770) 754-0085

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

LicenseStateTypeSpecialty
PT009754GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Wexcom Inc Dba Sharon B Wexler Past Accepting new patients
Shelland Physical Therapist Past Accepting new patients
Atlanta Physical Therapy Associates, Inc PastSince Feb 23, 2020 Accepting new patients

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.

NPI Registry JSON

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

{
    "created_epoch": "1253232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582156800000",
    "number": "1497088710",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3597 KESWICK DR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303412003"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3597 KESWICK DR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303412003",
            "telephone_number": "678-313-3872"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11940 Alpharetta Hwy",
            "address_2": "Suite 150",
            "address_purpose": "LOCATION",
            "city": "Alpharetta",
            "state": "GA",
            "postal_code": "300092003",
            "country_code": "US",
            "telephone_number": "770-754-0085",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "EWING",
        "first_name": "STEPHANIE",
        "middle_name": "WONG",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-18",
        "last_updated": "2020-02-20",
        "certification_date": "2020-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT009754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 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.

Verify at the official NPI Registry.