Active NPI
Olivia Dehan
- Physical Therapist
- Columbus, GA
National Provider Identifier
1750047445
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT014847
- Practice address
- 1519 13TH Ave
Columbus, GA 31901-1908 - Phone
- (706) 315-8175
- NPI assigned
- Nov 17, 2021
- 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 | PT014847 | GA | Primary |
Addresses
Primary practice location
1519 13TH Ave
Columbus, GA 31901-1908
Mailing address
1805 Vernon Rd
Ste a
Lagrange, GA 30240-3871
Phone (706) 845-9383
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT014847 | GA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1637107200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1642636800000",
"number": "1750047445",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1805 VERNON RD",
"address_2": "STE A",
"city": "LAGRANGE",
"state": "GA",
"postal_code": "302403871",
"telephone_number": "706-845-9383"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1519 13TH AVE",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319011908",
"telephone_number": "706-315-8175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DEHAN",
"first_name": "OLIVIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-11-17",
"last_updated": "2022-01-20",
"certification_date": "2022-01-20",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT014847",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Columbus, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.