Active NPI
Katherine Pennington, DPT
- Physical Therapist
- Loganville, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT011596
- Practice address
- 4743 Atlanta Hwy
Suite 100
Loganville, GA 30052-2666 - Phone
- (770) 466-9343
- Fax
- (770) 466-9345
- NPI assigned
- Sep 12, 2014
- 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 | PT011596 | GA | Primary |
Addresses
Primary practice location
4743 Atlanta Hwy
Suite 100
Loganville, GA 30052-2666
Mailing address
2400 Wisteria Dr
Suite a
Snellville, GA 30078-2689
Phone (770) 982-0102
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20150211001860 | GA | Practitioner - Physical Therapist in Private Practice | 5991020042 | Reassigns benefits to 1 organization |
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Mercer University School of Medicine, 2014
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Atlanta Rehabilitation and Performance Center
Practice addresses (Care Compare)
2801 N Decatur Rd
Suite 230
Decatur, GA 30033-7430
Phone (404) 294-7211
4220 Mundy Mill PL
Suite 2B
Oakwood, GA 30566-2573
Phone (678) 450-9933
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT011596 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Atlanta Rehabilitation and Performance Center | Current | Accepting new patients | |
| Atlanta Rehabilitation and Performance Center | Current | Accepting new patients |
Locations
2801 N Decatur Rd
Ste 230
Decatur, GA 30033
Phone (404) 294-7211
4743 Atlanta Hwy
Ste 100
Loganville, GA 30052
Phone (770) 466-9343
4220 Mundy Mill Pl
Ste 2B
Oakwood, GA 30566
Phone (678) 450-9933
2400 Wisteria Dr
Ste A
Snellville, GA 30078
Phone (770) 982-0102
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.
-
- Physical Therapy Clinic/Center
- Cleveland, GA
- NPI 1982797494
GA
-
- Physical Therapy Clinic/Center
- Lawrenceville, GA
- NPI 1013789205
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410480000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1410480000000",
"number": "1598166209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 WISTERIA DR",
"address_2": "SUITE A",
"city": "SNELLVILLE",
"state": "GA",
"postal_code": "300782689",
"telephone_number": "770-982-0102",
"fax_number": "770-982-0130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4743 ATLANTA HWY",
"address_2": "SUITE 100",
"city": "LOGANVILLE",
"state": "GA",
"postal_code": "300522666",
"telephone_number": "770-466-9343",
"fax_number": "770-466-9345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PENNINGTON",
"first_name": "KATHERINE",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-12",
"last_updated": "2014-09-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT011596",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Loganville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 12, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.