Active NPI
Keely Jordan
- Physical Therapist
- Acworth, GA
National Provider Identifier
1528640422
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Practice address
- 3540 Cobb Pkwy NW Ste 300
Acworth, GA 30101-4179 - Phone
- (678) 501-6300
- NPI assigned
- Apr 21, 2021
- Last updated
- Apr 21, 2021
- 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 | Primary |
Addresses
Primary practice location
3540 Cobb Pkwy NW Ste 300
Acworth, GA 30101-4179
Mailing address
1650 N Roberts Rd NW Apt 2113
Kennesaw, GA 30144-3777
Phone (731) 415-8488
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kennestone Hospital, Inc | Past | Accepting new patients | |
| Kennestone Hospital, Inc. | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
dba Wellstar Kennestone Hospital Inpatient Psych Unit
- Psychiatric Hospital Unit
- Atlanta, GA
- NPI 1689361438
-
dba Wellstar Windy Hill Hospital
- Long Term Care Hospital
- Marietta, GA
- NPI 1700853041
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1618963200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618963200000",
"number": "1528640422",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1650 N ROBERTS RD NW APT 2113",
"city": "KENNESAW",
"state": "GA",
"postal_code": "301443777",
"telephone_number": "731-415-8488"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3540 COBB PKWY NW STE 300",
"city": "ACWORTH",
"state": "GA",
"postal_code": "301014179",
"telephone_number": "678-501-6300"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JORDAN",
"first_name": "KEELY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-04-21",
"last_updated": "2021-04-21",
"certification_date": "2021-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Acworth, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 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.