Individual provider Active NPI

Lindsay Ballengee, PT

  • Physical Therapist
  • Lithonia, GA
National Provider Identifier
1861742728
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT011782 Issued in GA
Practice address
2410 Dekalb Medical Pkwy
Suite E
Lithonia, GA 30058-4999
Phone
(678) 418-8072
Fax
(678) 518-0137
NPI assigned
Sep 18, 2012
Last updated
Feb 3, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 070019098 IL
Physical Therapist 225100000X PT011782 GA Primary

Addresses

Primary practice location

2410 Dekalb Medical Pkwy
Suite E
Lithonia, GA 30058-4999

Mailing address

2410 Dekalb Medical Pkwy
Suite E
Lithonia, GA 30058-4999
Phone (678) 418-8072

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
16829NCMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Dekalb Comprehensive Physical Therapy Limited Partnership Past Accepting new patients

Organizations & group practices 1

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": "1347926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422921600000",
    "number": "1861742728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2410 DEKALB MEDICAL PKWY",
            "address_2": "SUITE E",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300584999",
            "telephone_number": "678-418-8072",
            "fax_number": "678-518-0137"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2410 DEKALB MEDICAL PKWY",
            "address_2": "SUITE E",
            "city": "LITHONIA",
            "state": "GA",
            "postal_code": "300584999",
            "telephone_number": "678-418-8072",
            "fax_number": "678-518-0137"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLENGEE",
        "first_name": "LINDSAY",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-09-18",
        "last_updated": "2015-02-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "070019098",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT011782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithonia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; 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.