Individual provider Active NPI

Kelsey Susanne Johnson

  • Physical Therapist
  • Snellville, GA
National Provider Identifier
1669029567
Registry record updated Aug 25, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT014281 Issued in GA
Practice address
2121 Fountain Dr Ste E
Snellville, GA 30078-2900
Phone
(770) 676-7028
NPI assigned
Aug 25, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2019

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 PT014281 GA Primary

Addresses

Primary practice location

2121 Fountain Dr Ste E
Snellville, GA 30078-2900

Mailing address

2121 Fountain Dr Ste E
Snellville, GA 30078-2900
Phone (770) 676-7028

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201216000119 GA Practitioner - Physical Therapist in Private Practice 6507278579 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Leger Therapy Services Inc.Group PAC ID 6406853415, 16 clinicians

Practice addresses (Care Compare)

402 Bombay LN
Roswell, GA 30076-5826
Phone (678) 878-2503

500 Lanier Ave W
Suite 303
Fayetteville, GA 30214-7636
Phone (770) 716-8885

500 W Lanier Ave
Suite 303
Fayetteville, GA 30214-7636
Phone (770) 716-8885

965 Piedmont Rd NE
Suite 200
Marietta, GA 30066-5493
Phone (770) 575-2212

Merit-based Incentive Payment System (MIPS)

Final score
82.85 of 100Reported as group
Quality
85.59
Improvement activities
40
Cost
69.27

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT014281GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Emory Physical Therapy, LLC CurrentSince Sep 18, 2023 Accepting new patients
Emory Physical Therapy, LLC CurrentSince Sep 18, 2023 Accepting new patients
Fox Rehabilitation Ga, LLC Physical Therapist CurrentSince Oct 1, 2020 Accepting new patients
Leger Therapy Services Inc. CurrentSince May 5, 2022 Accepting new patients
Emory Physical Therapy, LLC Current Accepting new patients
Georgia Luna Care Physical Therapy LLC Physical Therapist CurrentSince Aug 30, 2023 Accepting new patients

Locations

260 Peachtree St NW
Ste 2200
Atlanta, GA 30303
Phone (669) 231-6870

21 Ortho Ln
Atlanta, GA 30329
Phone (404) 778-2516

1845 Satellite Blvd
Ste 750
Duluth, GA 30097
Phone (404) 778-6490

500 Lanier Ave W
Ste 303
Fayetteville, GA 30214
Phone (770) 716-8885

965 Piedmont Rd NE
Ste 200
Marietta, GA 30066
Phone (770) 575-2212

402 Bombay Ln
Roswell, GA 30076
Phone (678) 878-2503

Organizations & group practices 6

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": "1566691200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1566691200000",
    "number": "1669029567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 FOUNTAIN DR STE E",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782900",
            "telephone_number": "770-676-7028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 FOUNTAIN DR STE E",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300782900",
            "telephone_number": "770-676-7028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "KELSEY",
        "middle_name": "SUSANNE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-25",
        "last_updated": "2019-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014281",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2019; 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.