Individual provider Active NPI

Michelle Ledford, PT MPT

  • Physical Therapist
  • Norcross, GA
National Provider Identifier
1942426937
Registry record updated Dec 28, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
GA006704 Issued in GA
Practice address
4261 Flippen TRL
Norcross, GA 30092-3927
Phone
(404) 931-7248
Fax
(404) 920-2154
NPI assigned
Apr 18, 2007
Last updated
Dec 28, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 28, 2020

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 PT0006704 GA
Physical Therapist 225100000X GA006704 GA Primary

Addresses

Primary practice location

4261 Flippen TRL
Norcross, GA 30092-3927

Mailing address

4261 Flippen TRL
Norcross, GA 30092-3927
Phone (404) 931-7248

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20090622000312 GA Practitioner - Physical Therapist in Private Practice 6204987803 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
BNB Wellness LLCGroup PAC ID 3870843188, 4 clinicians

Practice addresses (Care Compare)

1930 Bobby Jones Dr
Johns Creek, GA 30097-2402
Phone (404) 931-7248

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
GA006704GAMDPhysical Therapist
PT0006704GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
The Sports Rehabilitation Center PastSince Oct 3, 2011 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, 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": "1176854400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609113600000",
    "number": "1942426937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4261 FLIPPEN TRL",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300923927",
            "telephone_number": "404-931-7248",
            "fax_number": "404-477-8889"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4261 FLIPPEN TRL",
            "city": "NORCROSS",
            "state": "GA",
            "postal_code": "300923927",
            "telephone_number": "404-931-7248",
            "fax_number": "404-920-2154"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEDFORD",
        "first_name": "MICHELLE",
        "credential": "PT MPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-18",
        "last_updated": "2020-12-28",
        "certification_date": "2020-12-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT0006704",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "GA006704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Norcross, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 28, 2020; 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.