Individual provider Active NPI

Cherisse Mary Sansone, PT

  • Physical Therapist
  • Clayton, GA
National Provider Identifier
1952397002
Registry record updated Jul 27, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT006931 Issued in GA
Practice address
1218 N. Main St.
Clayton, GA 30525-3020
Phone
(706) 782-2585
Fax
(706) 782-2012
NPI assigned
Sep 23, 2005
Last updated
Jul 27, 2015By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 27, 2015

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 PT006931 GA Primary

Addresses

Primary practice location

1218 N. Main St.
Clayton, GA 30525-3020

Mailing address

PO Box 1397
Clayton, GA 30525-0035
Phone (706) 782-2585

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

LicenseStateTypeSpecialty
PT006931GAMDPhysical Therapist

Organizations & group practices 1

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": "1127433600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1437955200000",
    "number": "1952397002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1397",
            "city": "CLAYTON",
            "state": "GA",
            "postal_code": "305250035",
            "telephone_number": "706-782-2585",
            "fax_number": "706-782-2012"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1218 N. MAIN ST.",
            "city": "CLAYTON",
            "state": "GA",
            "postal_code": "305253020",
            "telephone_number": "706-782-2585",
            "fax_number": "706-782-2012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANSONE",
        "first_name": "CHERISSE",
        "middle_name": "MARY",
        "name_prefix": "Ms.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-09-23",
        "last_updated": "2015-07-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT006931",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clayton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 27, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.