Individual provider Active NPI

Paddyson Chukwuka Chidi, PT

  • Physical Therapist
  • Atlanta, GA
National Provider Identifier
1871853606
Registry record updated May 27, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
010191 Issued in GA
Practice address
3890 Redwine Rd SW
Suite 114
Atlanta, GA 30331-5582
Phone
(404) 344-7880
Fax
(404) 344-7881
NPI assigned
May 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 27, 2012

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 010191 GA Primary

Addresses

Primary practice location

3890 Redwine Rd SW
Suite 114
Atlanta, GA 30331-5582

Mailing address

3890 Redwine Rd SW
Suite 114
Atlanta, GA 30331-5582
Phone (404) 344-7880

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130104000423 GA Practitioner - Physical Therapist in Private Practice 9931141306 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Texas Tech University Health Science Center School of Medicine, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Peachtree Orthopaedic Clinic PAGroup PAC ID 4587552963, 138 clinicians

Practice addresses (Care Compare)

1901 Phoenix Blvd
Suite 200
College Park, GA 30349-5062
Phone (404) 355-6548

Merit-based Incentive Payment System (MIPS)

Final score
94.9 of 100Reported as group
Promoting interoperability
94
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
010191GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Peachtree Orthopaedic Clinic PA Physical Therapist CurrentSince Sep 10, 2018 Accepting new patients
Genesis Sports Medicine and Rehabilitation, LLC CurrentSince Mar 1, 2011 Accepting new patients
Peachtree Orthopaedic Clinic CurrentSince Sep 10, 2018 Accepting new patients
Stern at Home Physical Therapy PC Physical Therapist CurrentSince Jun 5, 2023 Accepting new patients

Locations

3890 Redwine Rd SW
Ste 114
Atlanta, GA 30331
Phone (404) 344-7880

2001 Peachtree Rd NE
Ste 705
Atlanta, GA 30309

1901 Phoenix Blvd
Ste 200
College Park, GA 30349
Phone (404) 355-6548

4 Medical Park Dr
Ste B
Pomona, NY 10970
Phone (845) 354-3131

Interoperability endpoints

  • Direct secure messaging: paddyson.chidi.1@8474.direct.athenahealth.com

Organizations & group practices 4

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": "1338076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338076800000",
    "number": "1871853606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3890 REDWINE RD SW",
            "address_2": "SUITE 114",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303315582",
            "telephone_number": "404-344-7880",
            "fax_number": "404-344-7881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3890 REDWINE RD SW",
            "address_2": "SUITE 114",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303315582",
            "telephone_number": "404-344-7880",
            "fax_number": "404-344-7881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHIDI",
        "first_name": "PADDYSON",
        "middle_name": "CHUKWUKA",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-27",
        "last_updated": "2012-05-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "010191",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 27, 2012; 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.