Individual provider Active NPI

Gina Misitano Thurman, OTR/L

  • Occupational Therapist
  • Marietta, GA
National Provider Identifier
1760566004
Registry record updated Jul 7, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT003903 Issued in GA
Practice address
1205 Johnson Ferry Rd
Ste 130
Marietta, GA 30068-5418
Phone
(770) 565-3201
Fax
(770) 565-3203
NPI assigned
Oct 24, 2006
Last updated
Jul 7, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 7, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X OT12415 FL
Occupational Therapist 225X00000X OT003903 GA Primary

Addresses

Primary practice location

1205 Johnson Ferry Rd
Ste 130
Marietta, GA 30068-5418

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

Other identifiers 1

IdentifierTypeStateIssuer
OT0039036OtherGAOCCUPATIONAL THERAPIST

Other names 1

  • Ms. Gina Marie Misitano Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110419000963 GA Practitioner - Occupational Therapist in Private Practice 3375645526 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Medical College of Georgia School of Medicine, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peachtree Orthopaedic Clinic PAGroup PAC ID 4587552963, 138 clinicians

Practice addresses (Care Compare)

1163 Johnson Ferry Rd
Suite 200
Marietta, GA 30068-2764
Phone (404) 355-0743

2001 Peachtree Rd NE
Suite 705
Atlanta, GA 30309-1476
Phone (404) 355-0743

Merit-based Incentive Payment System (MIPS)

Final score
94.9 of 100Reported as group
Promoting interoperability
94
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OT12415FLMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Benchmark Physical Therapy, Inc CurrentSince Mar 3, 2014 Accepting new patients
Independent Physical Therapy of Georgia, LLC Occupational Therapist CurrentSince Jan 6, 2014 Accepting new patients
Peachtree Orthopaedic Clinic CurrentSince Nov 27, 2023 Accepting new patients
Benchmark Physical Therapy, Inc Occupational Therapist CurrentSince Mar 3, 2014 Accepting new patients
Independent Physical Therapy of Georgia, LLC CurrentSince Jan 6, 2014 Accepting new patients
Independent Physical Therapy of Georgia, LLC Occupational Therapist Current Accepting new patients
Peachtree Orthopaedic Clinic PA Occupational Therapist CurrentSince Nov 27, 2023 Accepting new patients
Physiocare Inc PastSince Aug 16, 2013 Accepting new patients
Ability Pro Therapy, LLC Occupational Therapist PastSince Sep 15, 2016 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

2001 Peachtree Rd NE
Ste 705
Atlanta, GA 30309

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

1205 Johnson Ferry Rd
Ste 130
Marietta, GA 30068
Phone (770) 565-3201

11490 Alpharetta Hwy
Ste 200
Roswell, GA 30076
Phone (770) 740-8592

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (866) 518-0283

8823 Production Ln
Ooltewah, TN 37363
Phone (423) 238-8930

Organizations & group practices 9

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": "1161648000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1436227200000",
    "number": "1760566004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-954-7408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1205 JOHNSON FERRY RD",
            "address_2": "STE 130",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300685418",
            "telephone_number": "770-565-3201",
            "fax_number": "770-565-3203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THURMAN",
        "first_name": "GINA",
        "middle_name": "MISITANO",
        "name_prefix": "Mrs.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-24",
        "last_updated": "2015-07-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "FL",
            "license": "OT12415",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "GA",
            "license": "OT003903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OCCUPATIONAL THERAPIST",
            "identifier": "OT0039036",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "GINA",
            "last_name": "MISITANO",
            "middle_name": "MARIE",
            "prefix": "MS.",
            "credential": "OTR/L",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 2015; 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.