Individual provider Active NPI

Jill Nevella Newcomb-Campanelli, P.T.

  • Physical Therapist
  • Cumming, GA
National Provider Identifier
1972823284
Registry record updated Jun 9, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT008653 Issued in GA
Practice address
4640 Martin Rd
Suite 300
Cumming, GA 30041-5542
Phone
(678) 679-1261
Fax
(678) 679-1265
NPI assigned
Jun 9, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 9, 2010

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 PT008653 GA Primary
Physical Therapist 225100000X 9538 MA

Addresses

Primary practice location

4640 Martin Rd
Suite 300
Cumming, GA 30041-5542

Mailing address

3515 Rosewicke Dr
Cumming, GA 30040-7194
Phone (678) 756-1883

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
9538MAMDMechanotherapist
PT008653GAMDPhysical Therapist
008653GAMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Foundation Therapy Center-Alpharetta, LLC Physical Therapist Past Accepting new patients
Foundation Therapy Center - North Atlanta, LLC Physical Therapist PastSince May 1, 2017 Accepting new patients
Essential Therapy Services Past Accepting new patients
Essential Therapy Services, Inc. Past Accepting new patients
Reid Clinic Sports Physical Therapy and Spine LLC PastSince Aug 25, 2024 Accepting new patients

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1276041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1276041600000",
    "number": "1972823284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3515 ROSEWICKE DR",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300407194",
            "telephone_number": "678-756-1883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4640 MARTIN RD",
            "address_2": "SUITE 300",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300415542",
            "telephone_number": "678-679-1261",
            "fax_number": "678-679-1265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEWCOMB-CAMPANELLI",
        "first_name": "JILL",
        "middle_name": "NEVELLA",
        "credential": "P.T.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-09",
        "last_updated": "2010-06-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008653",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MA",
            "license": "9538",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cumming, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2010; 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.