Individual provider Active NPI

Dominique Nicole Simmons, DPT

  • Physical Therapist
  • Snellville, GA
National Provider Identifier
1881237410
Registry record updated Nov 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT014394 Issued in GA
Practice address
2059 Scenic Hwy N Ste C
Snellville, GA 30078-6142
Phone
(678) 344-7197
NPI assigned
Oct 27, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 25, 2024

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
Physical Therapist 225100000X PT014394 GA Primary

Addresses

Primary practice location

2059 Scenic Hwy N Ste C
Snellville, GA 30078-6142

Mailing address

1200 Corporate Dr Ste 400
Hoover, AL 35242-5424
Phone (866) 518-0283

Other practice location 1

3280 Hamilton Mill Rd Unit 109
Buford, GA 30519-7221
Phone (678) 804-8057

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241231000860 GA Practitioner - Physical Therapist in Private Practice 5193252211 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Agilitas USA, IncGroup PAC ID 3375454648, 812 clinicians
Benchmark Physical Therapy, IncGroup PAC ID 1557395209, 69 clinicians

Practice addresses (Care Compare)

10800 Alpharetta Hwy
Suite 176
Roswell, GA 30076-1463
Phone (678) 681-1060

11720 Medlock Bridge Rd
Suite 550
Johns Creek, GA 30097-2505
Phone (678) 364-7195

123 Battlefield Crossing CT
Ringgold, GA 30736-5176
Phone (706) 861-8775

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

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Dec 28, 2024 Accepting new patients
Agilitas USA, Inc Physical Therapist CurrentSince Dec 2, 2024 Accepting new patients
Independent Physical Therapy of Georgia, LLC Physical Therapist CurrentSince Dec 28, 2024 Accepting new patients
Benchmark Physical Therapy, Inc CurrentSince Dec 2, 2024 Accepting new patients
Agilitas USA Inc Physical Therapist CurrentSince Dec 2, 2024 Accepting new patients
Atlanta South Physical Therapy, Inc Physical Therapist CurrentSince Dec 2, 2024 Accepting new patients
Drayer Physical Therapy Georgia LLC Physical Therapist CurrentSince Dec 2, 2024 Accepting new patients

Locations

1200 Corporate Dr
Ste 400
Hoover, AL 35242
Phone (423) 238-7568

1025 E West Connector
Ste 406
Austell, GA 30106
Phone (770) 384-1001

7130 Mount Zion Blvd
Ste 9
Jonesboro, GA 30236
Phone (770) 603-5660

3455 Highway 81
Loganville, GA 30052
Phone (678) 635-8280

2059 Scenic Hwy N
Ste C
Snellville, GA 30078
Phone (470) 568-2818

6397 Lee Hwy
Ste 300
Chattanooga, TN 37421
Phone (423) 238-8923

Organizations & group practices 7

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": "1572134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732492800000",
    "number": "1881237410",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1200 CORPORATE DR STE 400",
            "city": "HOOVER",
            "state": "AL",
            "postal_code": "352425424",
            "telephone_number": "866-518-0283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2059 SCENIC HWY N STE C",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300786142",
            "telephone_number": "678-344-7197"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3280 Hamilton Mill Rd Unit 109",
            "address_purpose": "LOCATION",
            "city": "Buford",
            "state": "GA",
            "postal_code": "305197221",
            "country_code": "US",
            "telephone_number": "678-804-8057",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIMMONS",
        "first_name": "DOMINIQUE",
        "middle_name": "NICOLE",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-10-27",
        "last_updated": "2024-11-25",
        "certification_date": "2024-11-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Snellville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 25, 2024; 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.