Individual provider Active NPI

Teresa Ann Dawson, PT, DPT

  • Physical Therapist
  • Marietta, GA
National Provider Identifier
1689010456
Registry record updated Jul 1, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT012309 Issued in GA
Practice address
1205 Johnson Ferry Rd
Ste 130
Marietta, GA 30068-5418
Phone
(770) 565-3201
Fax
(770) 565-3203
NPI assigned
May 20, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2016

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 24290 MD
Physical Therapist 225100000X PT012309 GA Primary

Addresses

Primary practice location

1205 Johnson Ferry Rd
Ste 130
Marietta, GA 30068-5418

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

Other names 1

  • Teresa Ann Tiannucci Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160809000649 GA Practitioner - Physical Therapist in Private Practice 6406072719 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Integrated Therapy LLCGroup PAC ID 1153317300, 48 clinicians

Practice addresses (Care Compare)

4220 Lower Roswell Rd
Marietta, GA 30068-4128
Phone (404) 351-5307

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
24290MDMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Life Clinic of Ga PC Physical Therapist CurrentSince Dec 3, 2022 Accepting new patients
Integrated Therapy LLC Physical Therapist CurrentSince May 24, 2024 Accepting new patients
Preferred Podiatry Group PC PastSince May 24, 2024 Accepting new patients

Locations

855 North Point Pkwy
Alpharetta, GA 30005
Phone (952) 401-2336

2221 Peachtree Rd NE
Ste D336
Atlanta, GA 30309

4220 Lower Roswell Rd
Marietta, GA 30068
Phone (678) 946-4454

5600 Roswell Rd
Bldg I
Sandy Springs, GA 30342
Phone (404) 303-2323

Organizations & group practices 3

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": "1369008000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467331200000",
    "number": "1689010456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-362-8684"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 JOHNSON FERRY RD",
            "address_2": "STE 130",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300685418",
            "telephone_number": "770-565-3201",
            "fax_number": "770-565-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "TERESA",
        "middle_name": "ANN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-20",
        "last_updated": "2016-07-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "24290",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT012309",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TERESA",
            "last_name": "TIANNUCCI",
            "middle_name": "ANN",
            "credential": "DPT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 2016; 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.