Active NPI
Jill Nevella Newcomb-Campanelli, P.T.
- Physical Therapist
- Cumming, GA
National Provider Identifier
1972823284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT008653
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 9538 | MA | MD | Mechanotherapist |
| PT008653 | GA | MD | Physical Therapist |
| 008653 | GA | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Foundation Therapy Center-Alpharetta, LLC | Physical Therapist | Past | Accepting new patients |
| Foundation Therapy Center - North Atlanta, LLC | Physical Therapist | Past | 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 | Past | 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.
-
- Occupational Therapist
- Cumming, GA
- NPI 1043529373
-
- Occupational Therapist
- Cumming, GA
- NPI 1508077991
-
- Physical Therapist
- Atlanta, GA
- NPI 1962460451
-
- Physical Therapist
- Roswell, GA
- NPI 1447283635
-
- Physical Therapy Clinic/Center
- Roswell, GA
- NPI 1609106418
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.