Jessica Cushman, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT014935 Issued in GA

Practice address

4024 Lawrenceville Hwy NW Ste 19
Lilburn, GA 30047-2805

Phone

(770) 931-8686

NPI assigned

Oct 12, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Matrix Rehabilitation-Georgia Inc

  • Physical Therapy Clinic/Center
  • McDonough, GA
  • NPI 1659302966
  Medicare reassignment NPD
• Matrix Rehabilitation-Georgia Inc

  • Physical Therapy Clinic/Center
  • McDonough, GA
  • NPI 1427089853
  NPD (past)

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

{
    "created_epoch": "1602460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604448000000",
    "number": "1689272684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1454 W LAKE PL",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305011554",
            "telephone_number": "678-294-0928"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4024 LAWRENCEVILLE HWY NW STE 19",
            "city": "LILBURN",
            "state": "GA",
            "postal_code": "300472805",
            "telephone_number": "770-931-8686"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSHMAN",
        "first_name": "JESSICA",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-10-12",
        "last_updated": "2020-11-04",
        "certification_date": "2020-11-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT002969",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Aylishah Jamliah Crawford
• Creative Therapy Works LLC
• Nancy M Crews, LCSW
• Jamie Gynette Cross-Lee, LPC
• Josie Kou, Kulah Curran, RN, MSN, CDE
• Moosa Dalwai, DMD
• Nazneen Shamim Dalwai, D.M.D.
• Jessica Daly, RD,LD
• Ann Rosser Damon, PHARMD
• Anh-Thu Dang, DMD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 4, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.