Individual provider Active NPI

Jessica Marie Lanford, , DPT

  • Physical Therapist
  • Evans, GA
National Provider Identifier
1992321590
Registry record updated May 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT014616 Issued in GA
Practice address
601 N Belair SQ Ste 19
Evans, GA 30809-4324
Phone
(706) 831-1128
Fax
(770) 230-0157
NPI assigned
Jun 19, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 23, 2023

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 10268 SC
Physical Therapist 225100000X PT014616 GA Primary

Addresses

Primary practice location

601 N Belair SQ Ste 19
Evans, GA 30809-4324

Mailing address

601 N Belair SQ Ste 19
Evans, GA 30809-4324
Phone (706) 831-1128

Other names 1

  • Jessica M Eberhardt Former name

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PT014616GAMDPhysical Therapist
10268SCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Better Days Therapies of Augusta Physical Therapist CurrentSince Aug 6, 2023 Accepting new patients
Pediatric Therapy of Aiken, LLC Physical Therapist PastSince Jun 1, 2020 Accepting new patients
Pediatric Therapy of Aiken, LLC PastSince Dec 13, 2022 Accepting new patients

Locations

805 Oakhurst Dr
Ste A
Evans, GA 30809
Phone (706) 831-1128

601 N Belair Sq
Ste 19
Evans, GA 30809
Phone (706) 364-1486

Organizations & group practices 3

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": "1592524800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684800000000",
    "number": "1992321590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 N BELAIR SQ STE 19",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094324",
            "telephone_number": "706-831-1128",
            "fax_number": "770-230-0157"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 N BELAIR SQ STE 19",
            "city": "EVANS",
            "state": "GA",
            "postal_code": "308094324",
            "telephone_number": "706-831-1128",
            "fax_number": "770-230-0157"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LANFORD",
        "first_name": "JESSICA",
        "middle_name": "MARIE",
        "credential": ", DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-06-19",
        "last_updated": "2023-05-23",
        "certification_date": "2023-05-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "SC",
            "license": "10268",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT014616",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "EBERHARDT",
            "middle_name": "M",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Evans, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2023; 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.