Individual provider Active NPI

Amber Aldridge, PT, DPT

  • Physical Therapist
  • Bethlehem, GA
National Provider Identifier
1598492829
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT016059 Issued in GA
Practice address
380 Exchange Blvd Ste 103
Bethlehem, GA 30620-1853
Phone
(678) 218-9203
Fax
(470) 828-7003
NPI assigned
Aug 5, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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 PT016059 GA Primary

Addresses

Primary practice location

380 Exchange Blvd Ste 103
Bethlehem, GA 30620-1853

Mailing address

2400 Wisteria Dr Ste a
Snellville, GA 30078-2689
Phone (770) 982-0102

Other names 1

  • Amber Pallone Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220819001283 GA Practitioner - Physical Therapist in Private Practice 2466835780 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Philadelphia College of Osteopathic Medicine, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Atlanta Rehabilitation and Performance CenterGroup PAC ID 5890692917, 95 clinicians

Practice addresses (Care Compare)

575 Professional Dr
Suite 370
Lawrenceville, GA 30046-3334
Phone (678) 205-5420

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT016059GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Rehabilitation and Performance Center CurrentSince Aug 8, 2022 Accepting new patients
Atlanta Rehabilitation and Performance Center CurrentSince Aug 8, 2022 Accepting new patients

Locations

380 Exchange Blvd
Ste 103
Bethlehem, GA 30620
Phone (678) 218-9203

960 Lee St
Ste 205
Jefferson, GA 30549
Phone (706) 708-0001

575 Professional Dr
Ste 370
Lawrenceville, GA 30046
Phone (678) 205-5420

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.

NPI Registry JSON

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

{
    "created_epoch": "1659657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659657600000",
    "number": "1598492829",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2400 WISTERIA DR STE 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": "380 EXCHANGE BLVD STE 103",
            "city": "BETHLEHEM",
            "state": "GA",
            "postal_code": "306201853",
            "telephone_number": "678-218-9203",
            "fax_number": "470-828-7003"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ALDRIDGE",
        "first_name": "AMBER",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-08-05",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT016059",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "PALLONE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Bethlehem, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; 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.

Verify at the official NPI Registry.