Individual provider Active NPI

D'Anna Nicole Klinger, P.T.

  • Physical Therapist
  • Suwanee, GA
National Provider Identifier
1497899215
Registry record updated Jun 11, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT008973 Issued in GA
Practice address
3418 Rising Fawn TRL
Suwanee, GA 30024-3639
Phone
(706) 799-3515
Fax
(855) 396-0161
NPI assigned
Feb 16, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 11, 2021

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 PT008973 GA Primary

Addresses

Primary practice location

3418 Rising Fawn TRL
Suwanee, GA 30024-3639

Mailing address

3418 Rising Fawn TRL
Suwanee, GA 30024-3639
Phone (706) 799-3515

Other identifiers 1

IdentifierTypeStateIssuer
164236100AMedicaidGA

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

Practice roles

OrganizationSpecialtyStatusNew patients
Core Physical Therapy, PC PastSince Jan 22, 2007 Accepting new patients
Sports Medicine Associates of Augusta, LLC Physical Therapist Past Accepting new patients

Organizations & group practices 2

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": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623369600000",
    "number": "1497899215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3418 RISING FAWN TRL",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300243639",
            "telephone_number": "706-799-3515",
            "fax_number": "855-751-0172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3418 RISING FAWN TRL",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300243639",
            "telephone_number": "706-799-3515",
            "fax_number": "855-396-0161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLINGER",
        "first_name": "D'ANNA",
        "middle_name": "NICOLE",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2021-06-11",
        "certification_date": "2021-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008973",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "164236100A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Suwanee, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2021; 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.