Amy Meehan, PT, DPT, MTC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT010186 Issued in GA

Practice address

4805 Meadow Park LN
Suwanee, GA 30024-7325

Phone

(770) 800-2377

NPI assigned

Mar 30, 2015

Last updated

Sep 22, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Revelle Physical Therapy

  • Physical Therapy Clinic/Center
  • Chamblee, GA
  • NPI 1730795980
  NPD Authorized official
• Revelle Physical Therapy, LLC

  • Physical Therapy Clinic/Center
  • Greenwood Village, CO
  • NPI 1568183101
  NPD

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

{
    "created_epoch": "1427673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600732800000",
    "number": "1588059380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4805 MEADOW PARK LN",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300247325",
            "telephone_number": "478-954-9311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4805 MEADOW PARK LN",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300247325",
            "telephone_number": "770-800-2377"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3238 Lynwood Dr NE",
            "address_purpose": "LOCATION",
            "city": "Brookhaven",
            "state": "GA",
            "postal_code": "303192320",
            "country_code": "US",
            "telephone_number": "478-954-9311",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MEEHAN",
        "first_name": "AMY",
        "credential": "PT, DPT, MTC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-03-30",
        "last_updated": "2020-09-22",
        "certification_date": "2020-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT010186",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "info@therevelle.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "4805 Meadow Park Ln",
            "city": "Suwanee",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300247325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Physical Therapist in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2020; 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.