Individual provider Active NPI

Denise Edwards, PT

  • Physical Therapist
  • Stone Mountain, GA
National Provider Identifier
1750350328
Registry record updated Apr 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT007234 Issued in GA
Practice address
5295 Stone Mountain Hwy
Suite I
Stone Mountain, GA 30087-6416
Phone
(770) 879-5646
Fax
(770) 981-2024
NPI assigned
Mar 16, 2006
Last updated
Apr 18, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 18, 2014

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 PT007234 GA Primary

Addresses

Primary practice location

5295 Stone Mountain Hwy
Suite I
Stone Mountain, GA 30087-6416

Mailing address

5951 Fairington Farms LN
Lithonia, GA 30038-1545
Phone (770) 879-5646

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070424000399 GA Practitioner - Physical Therapist in Private Practice 6002911898 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Middle Georgia Family Rehab CurrentSince Jun 22, 2020 Accepting new patients
Children's 1St Rehabilitation Center, Inc CurrentSince Sep 6, 2020 Accepting new patients
Developmental & Rehabilitative Services 2, Inc Physical Therapist Current Accepting new patients

Locations

100 Hamilton Pointe Dr
Ste 115
Byron, GA 31008
Phone (478) 845-3520

4671 Mercer University Dr
Macon, GA 31210
Phone (478) 475-9990

239 Village Center Pkwy
Ste 190
Stockbridge, GA 30281
Phone (770) 628-1500

Organizations & group practices 4

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": "1142467200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397779200000",
    "number": "1750350328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5951 FAIRINGTON FARMS LN",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300381545",
            "telephone_number": "770-879-5646",
            "fax_number": "770-981-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5295 STONE MOUNTAIN HWY",
            "address_2": "SUITE I",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300876416",
            "telephone_number": "770-879-5646",
            "fax_number": "770-981-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDWARDS",
        "first_name": "DENISE",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-03-16",
        "last_updated": "2014-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT007234",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Stone Mountain, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2014; 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.

Verify at the official NPI Registry.