Individual provider Active NPI

Jessica Levin Waterman, PT, DPT

  • Physical Therapist
  • Austell, GA
National Provider Identifier
1962730994
Registry record updated Nov 24, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
9903 Issued in GA
Practice address
1025 E West Connector
Suite 406
Austell, GA 30106-8513
Phone
(770) 384-1101
Fax
(770) 384-0333
NPI assigned
Dec 2, 2009
Last updated
Nov 24, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 24, 2013

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 9903 GA Primary

Addresses

Primary practice location

1025 E West Connector
Suite 406
Austell, GA 30106-8513

Mailing address

8823 Production LN
Ooltewah, TN 37363-6511
Phone (423) 238-7217

Other identifiers 1

IdentifierTypeStateIssuer
PT009903OtherGAPHYSICAL THERAPIST

Other names 1

  • Jessical Lynn Levin Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180724002780 GA Practitioner - Physical Therapist in Private Practice 3678698594 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Turningpoint Breast Cancer Rehabilitation, IncGroup PAC ID 0244259810, 8 clinicians

Practice addresses (Care Compare)

8010 Roswell Rd
Suite 120
Atlanta, GA 30350-7013
Phone (770) 360-9271

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Turningpoint Breast Cancer Rehabilitation, Inc. CurrentSince Jun 1, 2018 Accepting new patients

Locations

8010 Roswell Rd
Ste 120
Sandy Springs, GA 30350
Phone (770) 360-9271

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": "1259712000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1385251200000",
    "number": "1962730994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8823 PRODUCTION LN",
            "city": "OOLTEWAH",
            "state": "TN",
            "postal_code": "373636511",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1025 E WEST CONNECTOR",
            "address_2": "SUITE 406",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301068513",
            "telephone_number": "770-384-1101",
            "fax_number": "770-384-0333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATERMAN",
        "first_name": "JESSICA",
        "middle_name": "LEVIN",
        "name_prefix": "Mrs.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-02",
        "last_updated": "2013-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "9903",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST",
            "identifier": "PT009903",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICAL",
            "last_name": "LEVIN",
            "middle_name": "LYNN",
            "credential": "PT, DPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Austell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2013; 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.