Individual provider Active NPI

Mariah Millsap

  • Physical Therapist
  • Gainesville, GA
National Provider Identifier
1659251932
Registry record updated Sep 19, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT017950 Issued in GA
Practice address
1640 Jesse Jewell Pkwy SE
Gainesville, GA 30501
Phone
(770) 982-0102
NPI assigned
Sep 5, 2025
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 19, 2025

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 PT017950 GA Primary

Addresses

Primary practice location

1640 Jesse Jewell Pkwy SE
Gainesville, GA 30501

Mailing address

1640 Jesse Jewell Pkwy SE
Gainesville, GA 30501

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251021003945 GA Practitioner - Physical Therapist in Private Practice 6305334426 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

1640 Jesse Jewell Pkwy SE
Suite 1a
Gainesville, GA 30501-2547
Phone (770) 536-9300

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT017950GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Atlanta Rehabilitation and Performance Center CurrentSince Aug 25, 2025 Accepting new patients
Atlanta Rehabilitation and Performance Center CurrentSince Aug 25, 2025 Accepting new patients

Locations

266 Shoe Factory Rd
Unit 6A
Blairsville, GA 30512
Phone (706) 487-7510

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": "1757030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1758240000000",
    "number": "1659251932",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1640 JESSE JEWELL PKWY SE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1640 JESSE JEWELL PKWY SE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "30501",
            "telephone_number": "770-982-0102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLSAP",
        "first_name": "MARIAH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-09-05",
        "last_updated": "2025-09-19",
        "certification_date": "2025-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT017950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Gainesville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 2025; 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.