Active NPI
Alicia Loraine Gregg, PT, DPT
- Physical Therapist
- Powder Springs, GA
National Provider Identifier
1497099204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- GA009879
- Practice address
- 115 Yellowstone LN
Powder Springs, GA 30127-6786 - Phone
- (678) 662-2643
- NPI assigned
- Nov 16, 2012
- 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 | GA009879 | GA | Primary |
Addresses
Primary practice location
115 Yellowstone LN
Powder Springs, GA 30127-6786
Mailing address
115 Yellowstone LN
Powder Springs, GA 30127-6786
Phone (678) 662-2643
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 |
|---|---|---|---|
| GA009879 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Life Clinic of Ga PC | Physical Therapist | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353024000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353024000000",
"number": "1497099204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "115 YELLOWSTONE LN",
"city": "POWDER SPRINGS",
"state": "GA",
"postal_code": "301276786",
"telephone_number": "678-662-2643"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "115 YELLOWSTONE LN",
"city": "POWDER SPRINGS",
"state": "GA",
"postal_code": "301276786",
"telephone_number": "678-662-2643"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREGG",
"first_name": "ALICIA",
"middle_name": "LORAINE",
"name_prefix": "Mrs.",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-11-16",
"last_updated": "2012-11-16",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "GA009879",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Powder Springs, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.