GREGORY A PEMBERTON (RPT AND OTR) – Physical Therapist, NPI 1093938722
Physical Therapist
Main info
Doctor Profile
Contacts
Profile Insights
NPPES metrics only — not quality of care.
490 OCCUPATIONAL THERAPIST IN PRIVATE PRACTICE in GA
Provider Addresses for GREGORY A PEMBERTON (RPT AND OTR)
2253 ALLEGHENY LANE
WATKINSVILLE, GA 306778347
Phone: (678) 753-1135
Fax: (678) 753-1173
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2025-01-24
PECOS data refreshed: 2026-06-15
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20250113001910 | I | Physical Therapist In Private Practice | SC | TBD |
| I20250124001483 | I | Occupational Therapist In Private Practice | SC | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30677)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | NM | |
| Physical Therapist In Private Practice | NJ | |
| Physical Therapist In Private Practice | IL | |
| Physical Therapist In Private Practice | SC | |
| Physical Therapist In Private Practice | NJ | |
| Occupational Therapist In Private Practice | SC | |
| - | SC | |
| Physical Therapist In Private Practice | SC | |
| Occupational Therapist In Private Practice | SC | |
| Occupational Therapist In Private Practice | SC |
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