Ashlee Graham, DPT
Individual provider Active NPI Physical Therapist · Harlem, GA
NPI 1700669264 · NPPES record last updated Aug 17, 2023
Key facts
- NPI
- 1700669264
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physical Therapist 225100000X
- License
- PT016753 (GA)
- Practice address
- 250 N Louisville St
Harlem, GA 30814-6012 - Phone
- (706) 986-0955
- NPI assigned
- Aug 17, 2023
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2023
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Georgialina Physical Therapy Associates LLC
Practice addresses (Care Compare)
250 N Louisville St
Harlem, GA 30814-6012
Phone (706) 986-0996
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260115003352 | GA | Practitioner - Physical Therapist in Private Practice | 1456838846 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT016753 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgialina Physical Therapy Associates LLC | Physical Therapist | Current |
Accepting new patients |
| Georgialina Physical Therapy Associates LLC | Physical Therapist | Current |
Accepting new patients |
Locations
1229 Friendship Rd
#200
Braselton, GA 30517
Phone (770) 415-9792
2122 York Rd
Ste 300
Oak Brook, IL 60523
Phone (630) 575-6250
Interoperability endpoints
- ashlee.graham.p12@direct.athleticoltd.nextgenshare.com
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT016753 | GA | Yes |
Addresses
Primary practice location
250 N Louisville St
Harlem, GA 30814-6012
Mailing address
2122 York Rd Ste 300
Oak Brook, IL 60523-1925
Phone (803) 349-4118
Other providers in Harlem, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 17, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.