Individual provider Active NPI

Ava Jakel, PT, DPT

  • Physical Therapist
  • Peachtree Corners, GA
National Provider Identifier
1740162502
Registry record updated Jul 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT017784 Issued in GA
Practice address
4941 S Old Peachtree Rd Ste D
Peachtree Corners, GA 30092-3495
Phone
(678) 335-2080
NPI assigned
Jul 23, 2025
Last updated
Jul 23, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 23, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT017784 GA Primary

Addresses

Primary practice location

4941 S Old Peachtree Rd Ste D
Peachtree Corners, GA 30092-3495

Mailing address

111 Ivey St
Clermont, GA 30527-1769
Phone (678) 897-3209

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251013001171 GA Practitioner - Physical Therapist in Private Practice 0143717322 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Pt360 Atl LLCGroup PAC ID 6406245489, 8 clinicians
Southeast Rehabilitation Group IncGroup PAC ID 7618341454, 6 clinicians

Practice addresses (Care Compare)

4920 Roswell Rd
Suite 36
Atlanta, GA 30342-2636
Phone (404) 464-8300

4941 S Old Peachtree Rd
Suite D
Peachtree Corners, GA 30092-3495
Phone (678) 335-2080

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT017784GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Pt360 Atl LLC Physical Therapist CurrentSince Oct 13, 2025 Accepting new patients
Southeast Rehabilitation Group Inc CurrentSince Aug 4, 2025 Accepting new patients

Locations

3400 Old Milton Pkwy
Ste C390
Alpharetta, GA 30005
Phone (404) 464-8300

4941 S Old Peachtree Rd
Peachtree Corners, GA 30092

4941 S Old Peachtree Rd
Ste D
Peachtree Corners, GA 30092
Phone (678) 335-2080

875 Mansell Rd
Ste H
Roswell, GA 30076
Phone (678) 821-2170

4920 Roswell Rd
Ste 36
Sandy Springs, GA 30342
Phone (404) 464-8300

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1753228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753228800000",
    "number": "1740162502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 IVEY ST",
            "city": "CLERMONT",
            "state": "GA",
            "postal_code": "305271769",
            "telephone_number": "678-897-3209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4941 S OLD PEACHTREE RD STE D",
            "city": "PEACHTREE CORNERS",
            "state": "GA",
            "postal_code": "300923495",
            "telephone_number": "678-335-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JAKEL",
        "first_name": "AVA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2025-07-23",
        "last_updated": "2025-07-23",
        "certification_date": "2025-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT017784",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Peachtree Corners, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 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.