Individual provider Active NPI

Sheldon Scott

  • Physical Therapist
  • Canton, GA
National Provider Identifier
1962467860
Registry record updated Aug 25, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
4853 Issued in GA
Practice address
15 Reinhardt College Pkwy
Suite 102
Canton, GA 30114-5257
Phone
(678) 505-4450
Fax
(678) 505-4447
NPI assigned
Apr 20, 2006
Last updated
Aug 25, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 25, 2014

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 4853 GA Primary

Addresses

Primary practice location

15 Reinhardt College Pkwy
Suite 102
Canton, GA 30114-5257

Mailing address

15 Reinhardt College Pkwy
Suite 102
Canton, GA 30114-5257
Phone (678) 505-4450

Other identifiers 1

IdentifierTypeStateIssuer
52748647OtherGASHELDON SCOTT BLUE CROSS#

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20061206000271 GA Practitioner - Physical Therapist in Private Practice 2264431949 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
4853GAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Resurgens, LLC CurrentSince Jun 15, 2021 Accepting new patients
A Step Ahead Physical Therapy, LLC CurrentSince Sep 10, 2012 Accepting new patients
Resurgens, LLC CurrentSince Jun 15, 2021 Accepting new patients
Pain Solutions Treatment Centers Past Accepting new patients
Business Intelligence Technology Past Accepting new patients
Athletic Spine Rehabilitation, LLC Physical Therapist PastSince Jul 1, 2017 Accepting new patients

Locations

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

15 Reinhardt College Pkwy
Ste 102
Canton, GA 30114
Phone (678) 505-4455

61 Whitcher St NE
Ste 1150
Marietta, GA 30060
Phone (678) 594-4250

790 Church St NE
Ste 300
Marietta, GA 30060
Phone (770) 422-3290

930 Woodstock Rd
Ste 310
Roswell, GA 30075
Phone (770) 998-6636

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

Interoperability endpoints

  • Direct secure messaging: sheldon.scott.1@15749.direct.athenahealth.com

Organizations & group practices 6

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": "1145491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408924800000",
    "number": "1962467860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15 REINHARDT COLLEGE PKWY",
            "address_2": "SUITE 102",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145257",
            "telephone_number": "678-505-4450",
            "fax_number": "678-505-4447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15 REINHARDT COLLEGE PKWY",
            "address_2": "SUITE 102",
            "city": "CANTON",
            "state": "GA",
            "postal_code": "301145257",
            "telephone_number": "678-505-4450",
            "fax_number": "678-505-4447"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCOTT",
        "first_name": "SHELDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-20",
        "last_updated": "2014-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "4853",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SHELDON SCOTT BLUE CROSS#",
            "identifier": "52748647",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Canton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.