Michaela Shea Fallon, PT, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

Practice address

4480 S Cobb Dr SE Ste Y
Smyrna, GA 30080-6984

Phone

(770) 438-5220

NPI assigned

Feb 21, 2022

Last updated

Feb 21, 2022By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1645401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1645401600000",
    "number": "1790430536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18468 LOST LAKE WAY",
            "city": "JUPITER",
            "state": "FL",
            "postal_code": "334583805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4480 S COBB DR SE STE Y",
            "city": "SMYRNA",
            "state": "GA",
            "postal_code": "300806984",
            "telephone_number": "770-438-5220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLON",
        "first_name": "MICHAELA",
        "middle_name": "SHEA",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-02-21",
        "last_updated": "2022-02-21",
        "certification_date": "2022-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ijeoma Ezegbo
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• Families First
• Family Behavioral Center P.C.
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• Family Tree Chiropractic PLLC
• Caragh Kelly Fane-Hervey

• Physical Therapist in Smyrna, GA
• Providers in Smyrna, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 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.

Verify at the official NPI Registry.