Individual provider Active NPI

Tessa Elliott, PT

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1528603933
Registry record updated Nov 8, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT011990 Issued in GA
Practice address
1392 McLendon Ave NE
Atlanta, GA 30307-2030
Phone
(404) 769-5544
NPI assigned
Nov 8, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2019

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 PT011990 GA Primary

Addresses

Primary practice location

1392 McLendon Ave NE
Atlanta, GA 30307-2030

Mailing address

738 Brookridge Dr NE
Atlanta, GA 30306-3617

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
PT011990GAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1573171200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1573171200000",
    "number": "1528603933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "738 BROOKRIDGE DR NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303063617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1392 MCLENDON AVE NE",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303072030",
            "telephone_number": "404-769-5544"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "TESSA",
        "name_prefix": "Dr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-11-08",
        "last_updated": "2019-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011990",
            "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 Nov 8, 2019; 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.