Active NPI
Sean Gardon
- Physical Therapist
- Cartersville, GA
National Provider Identifier
1912424201
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT012991
- Practice address
- 150 Gentilly Blvd
Cartersville, GA 30120-8522 - Phone
- (678) 719-7000
- Fax
- (678) 719-7003
- NPI assigned
- Aug 28, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT012991 | GA | Primary |
Addresses
Primary practice location
150 Gentilly Blvd
Cartersville, GA 30120-8522
Mailing address
PO Box 930402
Atlanta, GA 31193-1306
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT012991 | GA | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ascension All Saints Hospital, Inc | Past | Accepting new patients | |
| PT Solutions of Acworth LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
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.
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1503878400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1503878400000",
"number": "1912424201",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 930402",
"city": "ATLANTA",
"state": "GA",
"postal_code": "311931306"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "150 GENTILLY BLVD",
"city": "CARTERSVILLE",
"state": "GA",
"postal_code": "301208522",
"telephone_number": "678-719-7000",
"fax_number": "678-719-7003"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDON",
"first_name": "SEAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-08-28",
"last_updated": "2017-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT012991",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Cartersville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.