Active NPI
Christine Redovian, P.T.
- Physical Therapist
- Suwanee, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT004107
- Practice address
- 4310 Johns Creek Pkwy
100
Suwanee, GA 30024-6091 - Phone
- (770) 814-2900
- Fax
- (770) 814-7790
- NPI assigned
- Nov 8, 2006
- Last updated
- Jul 8, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | PT004107 | GA | Primary |
Addresses
Primary practice location
4310 Johns Creek Pkwy
100
Suwanee, GA 30024-6091
Mailing address
3656 Starwood TRL SW
Lilburn, GA 30047-2448
Phone (678) 362-8652
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5610 Hampton Park Dr
Cumming, GA 30041-4004
Phone (470) 866-5540
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT004107 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Empowerme Rehabilitation Georgia, LLC | Physical Therapist | Current | Accepting new patients |
Locations
5610 Hampton Park Dr
Cumming, GA 30041
Phone (470) 866-5540
1335 Strassner Dr
Saint Louis, MO 63144
Phone (314) 673-6723
Organizations & group practices 1
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.
-
- Multi-Specialty Clinic/Center
- Cumming, GA
- NPI 1952934374
Physical Therapist
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162944000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1649340928",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3656 STARWOOD TRL SW",
"city": "LILBURN",
"state": "GA",
"postal_code": "300472448",
"telephone_number": "678-362-8652",
"fax_number": "770-985-3656"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4310 JOHNS CREEK PKWY",
"address_2": "100",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300246091",
"telephone_number": "770-814-2900",
"fax_number": "770-814-7790"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REDOVIAN",
"first_name": "CHRISTINE",
"credential": "P.T.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-08",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT004107",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Suwanee, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.