Individual provider Active NPI

Crista Thoresen, PT

  • Physical Therapist
  • Blue Ridge, GA
National Provider Identifier
1790873651
Registry record updated Jan 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
7312 Issued in GA
Practice address
1600 Ballewtown Rd
Blue Ridge, GA 30513-5337
Phone
(706) 621-5686
Fax
(706) 621-5689
NPI assigned
Oct 10, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2022

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 7312 GA Primary

Addresses

Primary practice location

1600 Ballewtown Rd
Blue Ridge, GA 30513-5337

Mailing address

1600 Ballewtown Rd
Blue Ridge, GA 30513-5337
Phone (706) 621-5686

Other names 1

  • Crista Lawrence Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070129000518 GA Practitioner - Physical Therapist in Private Practice 7911908231 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Medical College of Georgia School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Weston Group IncGroup PAC ID 8123936796, 215 clinicians

Practice addresses (Care Compare)

85 Highland Ridge Rd
Ellijay, GA 30540-7116
Phone (762) 533-6292

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7312GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Weston Group Inc. Physical Therapist CurrentSince Apr 12, 2023 Accepting new patients
The Weston Group Inc. Physical Therapist CurrentSince Apr 12, 2023 Accepting new patients

Locations

1600 Ballewtown Rd
Blue Ridge, GA 30513
Phone (706) 621-5686

1100 Reinhardt College Pkwy
Canton, GA 30114
Phone (770) 721-2812

85 Highland Ridge Rd
Ellijay, GA 30540
Phone (706) 698-8400

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1790873651",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 BALLEWTOWN RD",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305135337",
            "telephone_number": "706-621-5686",
            "fax_number": "706-621-5689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 BALLEWTOWN RD",
            "city": "BLUE RIDGE",
            "state": "GA",
            "postal_code": "305135337",
            "telephone_number": "706-621-5686",
            "fax_number": "706-621-5689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORESEN",
        "first_name": "CRISTA",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "7312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CRISTA",
            "last_name": "LAWRENCE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Blue Ridge, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2022; 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.