Individual provider Active NPI

Hyomin Shin, DPT

  • Physical Therapist
  • Decatur, GA
National Provider Identifier
1649012790
Registry record updated Jun 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT017131 Issued in GA
Practice address
2550 Blackmon Dr Apt 5116
Decatur, GA 30033-6271
Phone
(470) 825-1062
NPI assigned
Jun 10, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2024

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 PT017131 GA Primary

Addresses

Primary practice location

2550 Blackmon Dr Apt 5116
Decatur, GA 30033-6271

Mailing address

2550 Blackmon Dr Apt 5116
Decatur, GA 30033-6271
Phone (470) 825-1062

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241126001883 GA Practitioner - Physical Therapist in Private Practice 5890220958 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Emory University School of Medicine, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

6055 Sandy Springs Cir
Sandy Springs, GA 30328-3863
Phone (305) 902-6644

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Agilitas USA, Inc Physical Therapist CurrentSince Sep 3, 2024 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Sep 3, 2024 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Sep 3, 2024 Accepting new patients
Benchmark Physical Therapy, Inc CurrentSince Sep 3, 2024 Accepting new patients
Benchmark Physical Therapy Inc Physical Therapist CurrentSince Sep 3, 2024 Accepting new patients
Physiologix Sports Physical Therapy LLC Physical Therapist CurrentSince Feb 1, 2025 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Sep 3, 2024 Accepting new patients
Physiologix Sports Physical Therapy PLLC Physical Therapist Past Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

2097 N Decatur Rd
Decatur, GA 30033
Phone (404) 634-7171

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

6055 Sandy Springs Cir
Sandy Springs, GA 30328
Phone (305) 902-6644

Organizations & group practices 8

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": "1717977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717977600000",
    "number": "1649012790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 BLACKMON DR APT 5116",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300336271",
            "telephone_number": "470-825-1062"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 BLACKMON DR APT 5116",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300336271",
            "telephone_number": "470-825-1062"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIN",
        "first_name": "HYOMIN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-06-10",
        "last_updated": "2024-06-10",
        "certification_date": "2024-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT017131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2024; 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.