Individual provider Active NPI

Jennifer Bowman Herzwurm, DPT

  • Physical Therapist
  • Milton, GA
National Provider Identifier
1669602397
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Practice address
12990 Highway 9 N Ste 110
Milton, GA 30004-4196
Phone
(770) 751-0095
NPI assigned
Jul 15, 2009
Last updated
Oct 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 61970 OR
Physical Therapist 225100000X Primary

Addresses

Primary practice location

12990 Highway 9 N Ste 110
Milton, GA 30004-4196

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424

Other practice location 1

497 SW Ramsey Ave
Grants Pass, OR 97527-5681
Phone (541) 476-1919

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100302000405 GA Practitioner - Physical Therapist in Private Practice 6305981390 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Emory University School of Medicine, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians

Practice addresses (Care Compare)

123 Battlefield Crossing CT
Ringgold, GA 30736-5176
Phone (706) 861-8775

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
61970ORMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Georgia Luna Care Physical Therapy LLC Physical Therapist CurrentSince Feb 14, 2024 Accepting new patients
Emory Physical Therapy, LLC CurrentSince Feb 19, 2024 Accepting new patients
Benchmark Physical Therapy Inc Physical Therapist CurrentSince Sep 29, 2023 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Sep 29, 2023 Accepting new patients
Emory Physical Therapy, LLC CurrentSince Feb 19, 2024 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Sep 29, 2023 Accepting new patients
Emory Physical Therapy, LLC Current Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Sep 29, 2023 Accepting new patients
Drayer Physical Therapy Georgia LLC Physical Therapist CurrentSince Sep 29, 2023 Accepting new patients
PT Solutions of Acworth, LLC Physical Therapist Past Accepting new patients

Locations

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

12850 Highway 9 N
Ste 1050
Alpharetta, GA 30004
Phone (678) 332-5800

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

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

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

7201 Turner Lake Rd NW
Ste 13
Covington, GA 30014
Phone (470) 444-1609

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

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

3455 Highway 81
Loganville, GA 30052
Phone (678) 635-8280

12990 Highway 9 N
Ste 110
Milton, GA 30004
Phone (770) 751-0095

11490 Alpharetta Hwy
Ste 200
Roswell, GA 30076
Phone (770) 740-8592

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

8823 Production Ln
Ooltewah, TN 37363
Phone (423) 238-8923

Organizations & group practices 11

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": "1247616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697587200000",
    "number": "1669602397",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12990 HIGHWAY 9 N STE 110",
            "city": "MILTON",
            "state": "GA",
            "postal_code": "300044196",
            "telephone_number": "770-751-0095"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "497 SW Ramsey Ave",
            "address_purpose": "LOCATION",
            "city": "Grants Pass",
            "state": "OR",
            "postal_code": "975275681",
            "country_code": "US",
            "telephone_number": "541-476-1919",
            "fax_number": "541-476-1920",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HERZWURM",
        "first_name": "JENNIFER",
        "middle_name": "BOWMAN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-15",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "OR",
            "license": "61970",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.