Active NPI
Bayo U Sedenu, PT, PHD
- Physical Therapist
- Lawrenceville, GA
National Provider Identifier
1982043048
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT011267
- Practice address
- 1301 Low Water Way
Lawrenceville, GA 30045-7079 - Phone
- (678) 894-5628
- Fax
- (770) 559-7538
- NPI assigned
- Jun 21, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 5
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 14243 | NC | |
| Physical Therapist | 225100000X | PT011267 | GA | Primary |
| Physical Therapist | 225100000X | PT 28335 | FL | |
| Physical Therapist | 225100000X | 010854-1 | NY | |
| Physical Therapist | 225100000X | 7061 | SC |
Addresses
Primary practice location
1301 Low Water Way
Lawrenceville, GA 30045-7079
Mailing address
1301 Low Water Way
Lawrenceville, GA 30045-7079
Phone (678) 894-5628
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PT011267 | Other | GA | BOARD OF PHYSICAL THERAPY |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7061 | SC | MD | Professional Counselor |
| 14243 | NC | MD | General Practice Dentistry |
| PT 28335 | FL | MD | Physical Therapist |
| PT011267 | GA | MD | Physical Therapist |
| 010854-1 | NY | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1371772800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1409875200000",
"number": "1982043048",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1301 LOW WATER WAY",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300457079",
"telephone_number": "678-894-5628",
"fax_number": "770-559-7538"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 LOW WATER WAY",
"city": "LAWRENCEVILLE",
"state": "GA",
"postal_code": "300457079",
"telephone_number": "678-894-5628",
"fax_number": "770-559-7538"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEDENU",
"first_name": "BAYO",
"middle_name": "U",
"name_prefix": "Dr.",
"credential": "PT, PHD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-06-21",
"last_updated": "2014-09-05",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NC",
"license": "14243",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "GA",
"license": "PT011267",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "FL",
"license": "PT 28335",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NY",
"license": "010854-1",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "SC",
"license": "7061",
"primary": false
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BOARD OF PHYSICAL THERAPY",
"identifier": "PT011267",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 5, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.