Individual provider Active NPI

Jessica Patrice Thompson, PT, DPT

  • Physical Therapist
  • Decatur, GA
National Provider Identifier
1801405683
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT014609 Issued in GA
Practice address
141 Sams St Ste a
Decatur, GA 30030-4101
Phone
(404) 296-8511
Fax
(404) 296-8514
NPI assigned
Jul 28, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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 PT014609 GA Primary

Addresses

Primary practice location

141 Sams St Ste a
Decatur, GA 30030-4101

Mailing address

1200 Corporate Dr Ste 400
Birmingham, AL 35242-5424
Phone (423) 238-7217

Other practice location 1

4825 Sugarloaf Pkwy Ste C
Lawrenceville, GA 30044-8800
Phone (678) 985-0238

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

State licenses

LicenseStateTypeSpecialty
PT014609GAMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1595894400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1801405683",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "BIRMINGHAM",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 SAMS ST STE A",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300304101",
            "telephone_number": "404-296-8511",
            "fax_number": "404-296-8514"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4825 Sugarloaf Pkwy Ste C",
            "address_purpose": "LOCATION",
            "city": "Lawrenceville",
            "state": "GA",
            "postal_code": "300448800",
            "country_code": "US",
            "telephone_number": "678-985-0238",
            "fax_number": "678-985-0136",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "JESSICA",
        "middle_name": "PATRICE",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-28",
        "last_updated": "2023-09-25",
        "certification_date": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2023; 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.