Al Wynne Querubin Gesite, P.T.

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

5853 Issued in GA

Practice address

670 North Ave NW
Suite C
Marietta, GA 30060-1100

Phone

(404) 771-0554

Fax

(770) 442-3490

NPI assigned

Mar 6, 2008

Sex

Male

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

Enrolled in GA

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Physioedge, LLCGroup PAC ID 9931275856, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Physioedge, LLC

  • Physical Therapy Clinic/Center
  • Marietta, GA
  • NPI 1982874863
  Medicare reassignment Care Compare group NPD Authorized official
• Global Orthopedic Physical Therapy, Inc

  • Physical Therapist
  • Alpharetta, GA
  • NPI 1922218734
  NPD (past) Authorized official
• Integrated Therapy LLC

  • Physical Therapist
  • Atlanta, GA
  • NPI 1326247248
  NPD (past)
• Life Clinic of Ga PC

  • Chiropractor
  • Woodstock, GA
  • NPI 1922752807

  Physical Therapist

  NPD (past)

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

{
    "created_epoch": "1204761600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1204761600000",
    "number": "1801066790",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8020 WOODLAND LN",
            "city": "ALPHARETTA",
            "state": "GA",
            "postal_code": "300048725",
            "telephone_number": "404-771-0554",
            "fax_number": "770-442-3490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "670 NORTH AVE NW",
            "address_2": "SUITE C",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300601100",
            "telephone_number": "404-771-0554",
            "fax_number": "770-442-3490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GESITE",
        "first_name": "AL WYNNE",
        "middle_name": "QUERUBIN",
        "credential": "P.T.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-03-06",
        "last_updated": "2008-03-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "5853",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Georgia Urology PA
• Geriatric Eye Group LLC
• Roberto Gerjoi, D.C.
• Get Ready Baby, LLC
• Mayssoun Ghawi
• Christine Ghilain, PHD
• Gi Diagnostics Endoscopy Center, LLC
• Annamarie Giangiacomo

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2008; 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.