Individual provider Active NPI

Jason Salisbury, PT, DPT

  • Physical Therapist
  • Dallas, GA
National Provider Identifier
1649670746
Registry record updated Sep 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT011605 Issued in GA
Practice address
8492 Hiram Acworth Hwy Ste 211
Dallas, GA 30157-4710
Phone
(678) 687-0630
Fax
(678) 647-7985
NPI assigned
Aug 26, 2014
Last updated
Sep 20, 2023By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2023

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 PT011605 GA Primary

Addresses

Primary practice location

8492 Hiram Acworth Hwy Ste 211
Dallas, GA 30157-4710

Mailing address

8492 Hiram Acworth Hwy Ste 211
Dallas, GA 30157-4710
Phone (678) 687-0630

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20190501003011 GA Practitioner - Physical Therapist in Private Practice 1254673783 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

8492 Hiram Acworth Hwy
Dallas, GA 30157-4710
Phone (678) 687-0630

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT011605GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Salisbury Physical Therapy, LLC Physical Therapist CurrentSince May 24, 2023 Accepting new patients
Free Life Physical Therapy Physical Therapist Current Accepting new patients

Locations

8492 Hiram Acworth Hwy
Ste 211
Dallas, GA 30157
Phone (678) 687-0630

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1409011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695168000000",
    "number": "1649670746",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8492 HIRAM ACWORTH HWY STE 211",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301574710",
            "telephone_number": "678-687-0630",
            "fax_number": "678-647-7985"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8492 HIRAM ACWORTH HWY STE 211",
            "city": "DALLAS",
            "state": "GA",
            "postal_code": "301574710",
            "telephone_number": "678-687-0630",
            "fax_number": "678-647-7985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SALISBURY",
        "first_name": "JASON",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-08-26",
        "last_updated": "2023-09-20",
        "certification_date": "2023-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011605",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2023; 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.