Individual provider Active NPI

Autumn Rachel Ulrich, PT

  • Orthopedic Physical Therapist
  • Kennesaw, GA
National Provider Identifier
1932161940
Registry record updated Mar 18, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT007378 Issued in GA
Practice address
270 Chastain Rd NW
Kennesaw, GA 30144-3012
Phone
(678) 594-6080
Fax
(678) 594-6081
NPI assigned
Apr 5, 2006
Last updated
Mar 18, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 18, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical Therapist 2251X0800X PT007378 GA Primary

Addresses

Primary practice location

270 Chastain Rd NW
Kennesaw, GA 30144-3012

Mailing address

270 Chastain Rd NW
Kennesaw, GA 30144-3012
Phone (678) 594-6080

Other names 1

  • Autumn Rachel Brown Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211215000536 GA Practitioner - Physical Therapist in Private Practice 8628469228 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
93.93 of 100Reported as apm
Quality
82.14
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
PT007378GAMDOrthopedic Physical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Resurgens, LLC CurrentSince Nov 1, 2021 Accepting new patients
Resurgens, LLC CurrentSince Nov 1, 2021 Accepting new patients

Locations

2041 Mesa Valley Way
Ste 100
Austell, GA 30106
Phone (770) 944-1100

270 Chastain Rd NW
Kennesaw, GA 30144
Phone (678) 594-6080

5671 Ptree Dunwoody Rd NE
Ste 700
Sandy Springs, GA 30342
Phone (404) 459-3732

5671 Ptree Dunwoody Rd NE
Ste 900
Sandy Springs, GA 30342
Phone (404) 531-8590

1600 Medical Way
Ste 150
Snellville, GA 30078
Phone (770) 978-5328

Interoperability endpoints

  • Direct secure messaging: autumn.ulrich.1@15749.direct.athenahealth.com

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, 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": "1144195200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1268870400000",
    "number": "1932161940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "270 CHASTAIN RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301443012",
            "telephone_number": "678-594-6080",
            "fax_number": "678-594-6081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 CHASTAIN RD NW",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "301443012",
            "telephone_number": "678-594-6080",
            "fax_number": "678-594-6081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ULRICH",
        "first_name": "AUTUMN",
        "middle_name": "RACHEL",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-04-05",
        "last_updated": "2010-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "GA",
            "license": "PT007378",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AUTUMN",
            "last_name": "BROWN",
            "middle_name": "RACHEL",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kennesaw, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2010; 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.