Active NPI
Tessa Elliott, PT
- Physical Therapist
- Atlanta, GA
National Provider Identifier
1528603933
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT011990
- 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
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 | 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
| License | State | Type | Specialty |
|---|---|---|---|
| PT011990 | GA | MD | Physical 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.