Ketreena Roshawn Footman, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT013495 Issued in GA

Practice address

3939 Atlanta Hwy
Loganville, GA 30052-3761

Phone

(770) 884-2800

Fax

(770) 884-2805

NPI assigned

Jul 15, 2013

Last updated

Jun 9, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Team Rehabilitation Services LLCGroup PAC ID 2264479518, 569 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

81.73 of 100Reported as group

Quality

87.86

Improvement activities

40

Cost

61.36

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Networks

• Optimum HealthCare HMO Network
• Freedom Health HMO Network

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/327/brand/1/csg/21/fhir/r4

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.

• Team Rehabilitation Services, LLC

  • Physical Therapist
  • Marietta, GA
  • NPI 1508538158
  Medicare reassignment Care Compare group NPD
• Benchmark Physical Therapy, Inc

  • Physical Therapy Clinic/Center
  • Duluth, GA
  • NPI 1083666903
  Medicare reassignment NPD
• Independent Physical Therapy of Georgia, LLC

  dba BenchMark Physical Therapy

  • Physical Therapist
  • Fort Oglethorpe, GA
  • NPI 1780636068
  Medicare reassignment NPD
• Piedmont Orthopedics, LLC

  • Orthopaedic Surgery Physician
  • Atlanta, GA
  • NPI 1114317062
  Medicare reassignment NPD
• Orthoatlanta, LLC

  • Orthopaedic Surgery Physician
  • Newnan, GA
  • NPI 1851937114
  Medicare reassignment
• Benchmark Physical Therapy, Inc

  • Physical Therapist
  • Fayetteville, GA
  • NPI 1669703674
  NPD
• Independent Physical Therapy of Georgia, LLC

  • Physical Therapy Clinic/Center
  • Villa Rica, GA
  • NPI 1013292135
  NPD
• Independent Physical Therapy of Georgia, LLC

  dba Benchmark PT

  • Occupational Therapist
  • Gainesville, GA
  • NPI 1306013941

  Physical Therapist

  NPD
• Orthoatlanta, LLC

  • Orthopaedic Surgery Physician
  • Douglasville, GA
  • NPI 1033855408
  NPD
• Orthoatlanta, LLC

  • Orthopaedic Surgery Physician
  • Evans, GA
  • NPI 1679251920
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1654732800000",
    "number": "1689015026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33900 HARPER AVE STE 104",
            "city": "CLINTON TWP",
            "state": "MI",
            "postal_code": "480354258",
            "telephone_number": "586-350-2644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3939 ATLANTA HWY",
            "city": "LOGANVILLE",
            "state": "GA",
            "postal_code": "300523761",
            "telephone_number": "770-884-2800",
            "fax_number": "770-884-2805"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "325 MDG",
            "address_2": "340 Magnolia Circle",
            "address_purpose": "LOCATION",
            "city": "Tyndall AFB",
            "state": "FL",
            "postal_code": "32403",
            "country_code": "US",
            "telephone_number": "850-283-7019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FOOTMAN",
        "first_name": "KETREENA",
        "middle_name": "ROSHAWN",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-15",
        "last_updated": "2022-06-09",
        "certification_date": "2022-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "FL",
            "license": "PT27492",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "7411",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT013495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leland Seth Fleming, ATC
• Shelley Flemming, DOT
• Flourish Physiatry LLC
• Brionne Folds
• Morgan Ashley Foley
• Patricia Lynn Ford
• Shakeia Yetta Ford, RN
• Karin Downing Foster, MOT, OTR/L, CHT
• Chester Allen Fowler, LPC
• Aleijah Imani Foxworth-Mandhu, MD

• Physical Therapist in Loganville, GA
• Providers in Loganville, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2022; 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.