Individual provider Active NPI

Mandy G Osburn, MPT

  • Physical Therapist
  • Fayetteville, GA
National Provider Identifier
1710248901
Registry record updated May 30, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT007788 Issued in GA
Practice address
1265 Highway 54 W
Suite 102 & 308
Fayetteville, GA 30214-4548
Phone
(770) 460-1900
Fax
(770) 719-1214
NPI assigned
Jun 4, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 30, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT007788 GA
Physical Therapist 225100000X PT007788 GA Primary

Addresses

Primary practice location

1265 Highway 54 W
Suite 102 & 308
Fayetteville, GA 30214-4548

Mailing address

900 Circle 75 Pkwy SE
Suite 1700
Atlanta, GA 30339-3035
Phone (770) 953-6929

Electronic endpoints 3

TypeEndpointUseAffiliation
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehabilitation GA, LLC
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehabilitation GA, LLC
CONNECT URL https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler Other Fox Rehabilitation GA, LLC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120702000016 GA Practitioner - Physical Therapist in Private Practice 6901061654 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Group practices
Fox Rehabilitation Ga, LLC 109 clinicians

Practice addresses (Care Compare)

Duluth, GA 30097
Phone (877) 407-3422

Merit-based Incentive Payment System (MIPS)

Final score
81.13 of 100Reported as group
Quality
82.29
Improvement activities
40
Cost
59.2

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
TX: Team Rehab Inc. Physical Therapist CurrentSince Jan 17, 2023 Accepting new patients
Fox Rehabilitation Ga, LLC Physical Therapist CurrentSince Apr 1, 2025 Accepting new patients
Orthoatlanta, LLC Past Accepting new patients

Locations

3090 Premiere Pkwy
Ste 400
Duluth, GA 30097
Phone (770) 624-2727

8601 Dunwoody Pl
Ste 130
Sandy Springs, GA 30350
Phone (404) 595-2034

8910 Purdue Rd
Ste 700
Indianapolis, IN 46268

9101 Wesleyan Rd
Ste 100
Indianapolis, IN 46268
Phone (843) 873-7613

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": "1338768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748563200000",
    "number": "1710248901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CIRCLE 75 PKWY SE",
            "address_2": "SUITE 1700",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303393035",
            "telephone_number": "770-953-6929",
            "fax_number": "770-953-6972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 HIGHWAY 54 W",
            "address_2": "SUITE 102 & 308",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144548",
            "telephone_number": "770-460-1900",
            "fax_number": "770-719-1214"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSBURN",
        "first_name": "MANDY",
        "middle_name": "G",
        "credential": "MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-06-04",
        "last_updated": "2025-05-30",
        "certification_date": "2025-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "GA",
            "license": "PT007788",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT007788",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehabilitation GA, LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1260 Hightower Trl",
            "city": "Atlanta",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303506248",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehabilitation GA, LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "3090 Premiere Pkwy Ste 400",
            "city": "Duluth",
            "state": "GA",
            "country_code": "US",
            "postal_code": "300978915",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://www.cms.gov/research-statistics-data-systems/electronic-submission-medical-documentation-esmd/cms-health-information-handler",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.13.34.110.1.998.01",
            "affiliationName": "Fox Rehabilitation GA, LLC",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "8601 Dunwoody Pl Ste 130",
            "city": "Sandy Springs",
            "state": "GA",
            "country_code": "US",
            "postal_code": "303502517",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.