Active NPI
Crystal Reitman
- Physical Therapist
- Roswell, GA
National Provider Identifier
1750832408
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT012664
- Practice address
- 402 Bombay LN
Roswell, GA 30076-5826 - Phone
- (678) 878-2503
- Fax
- (648) 878-2505
- NPI assigned
- Oct 18, 2016
- 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 | PT012664 | GA | Primary |
Addresses
Primary practice location
402 Bombay LN
Roswell, GA 30076-5826
Mailing address
402 Bombay LN
Roswell, GA 30076-5826
Phone (678) 878-2503
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1476748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1476748800000",
"number": "1750832408",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "402 BOMBAY LN",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300765826",
"telephone_number": "678-878-2503",
"fax_number": "648-878-2505"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "402 BOMBAY LN",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300765826",
"telephone_number": "678-878-2503",
"fax_number": "648-878-2505"
}
],
"practiceLocations": [],
"basic": {
"last_name": "REITMAN",
"first_name": "CRYSTAL",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-10-18",
"last_updated": "2016-10-18",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT012664",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roswell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.