Individual provider Active NPI

Erin F Black

  • Physical Therapist
  • Dacula, GA
National Provider Identifier
1679107544
Registry record updated Sep 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT017981 Issued in GA
Practice address
2515 Fence Rd Ste 160
Dacula, GA 30019-2138
Phone
(770) 237-2852
NPI assigned
Feb 28, 2020
Last updated
Sep 11, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2025

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 302129 CA
Physical Therapist 225100000X PT017981 GA Primary
Geriatric Physical Therapist 2251G0304X 35615 FL

Addresses

Primary practice location

2515 Fence Rd Ste 160
Dacula, GA 30019-2138

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (423) 238-7217

Other practice location 1

2300 Bluff Oak Way Apt 5104
Tallahassee, FL 32311-6129
Phone (903) 452-6493

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251029004863 GA Practitioner - Physical Therapist in Private Practice 6608244520 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

2515 Fence Rd
Suite 160
Dacula, GA 30019-2138
Phone (770) 237-2852

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
302129CAMDPhysical Therapist
PT017981GAMDPhysical Therapist
35615FLMDGeriatric Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy, Inc CurrentSince Sep 5, 2025 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Sep 5, 2025 Accepting new patients
Benchmark Physical Therapy Inc Physical Therapist CurrentSince Sep 5, 2025 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Sep 5, 2025 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Sep 5, 2025 Accepting new patients
Camarillo Physical Therapy, Inc Physical Therapist CurrentSince Jun 17, 2026 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Sep 5, 2025 Accepting new patients
Camarillo Physical Therapy Physical Therapist PastSince Jun 17, 2026 Accepting new patients

Locations

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

4000 Calle Tecate
Ste 117
Camarillo, CA 93012
Phone (805) 383-0470

850 Hampshire Rd
Ste Ab
Westlake Village, CA 91361
Phone (805) 383-0470

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

2515 Fence Rd
Ste 160
Dacula, GA 30019
Phone (770) 237-2852

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

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

Organizations & group practices 8

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": "1582848000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757548800000",
    "number": "1679107544",
    "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",
            "telephone_number": "423-238-7217"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2515 FENCE RD STE 160",
            "city": "DACULA",
            "state": "GA",
            "postal_code": "300192138",
            "telephone_number": "770-237-2852"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2300 Bluff Oak Way Apt 5104",
            "address_purpose": "LOCATION",
            "city": "Tallahassee",
            "state": "FL",
            "postal_code": "323116129",
            "country_code": "US",
            "telephone_number": "903-452-6493",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BLACK",
        "first_name": "ERIN",
        "middle_name": "F",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-28",
        "last_updated": "2025-09-11",
        "certification_date": "2025-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CA",
            "license": "302129",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT017981",
            "primary": true
        },
        {
            "code": "2251G0304X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Geriatrics",
            "state": "FL",
            "license": "35615",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dacula, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 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.