Active NPI
Jordan Huey
- Physical Therapist
- Dacula, GA
National Provider Identifier
1730598111
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT011566
- Practice address
- 3615 Braselton Hwy
101
Dacula, GA 30019-5906 - Phone
- (770) 904-0772
- NPI assigned
- Aug 11, 2014
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT011566 | GA | Primary |
Addresses
Primary practice location
3615 Braselton Hwy
101
Dacula, GA 30019-5906
Mailing address
4779 S Atlanta Rd SE
Ste 200
Atlanta, GA 30339-1565
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210803002941 | GA | Practitioner - Physical Therapist in Private Practice | 7416351176 |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT011566 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Physiotherapy Associates Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
-
dba Select Physical Therapy
- Physical Therapy Clinic/Center
- Estero, FL
- NPI 1720039902
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1407715200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1627344000000",
"number": "1730598111",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4779 S ATLANTA RD SE",
"address_2": "STE 200",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303391565"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3615 BRASELTON HWY",
"address_2": "101",
"city": "DACULA",
"state": "GA",
"postal_code": "300195906",
"telephone_number": "770-904-0772"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HUEY",
"first_name": "JORDAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-08-11",
"last_updated": "2021-07-27",
"certification_date": "2021-07-27",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT011566",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dacula, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2021; 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.