RUDO ALICE TAKAWIRA (PT) – Physical Therapist, NPI 1104331206

RUDO ALICE TAKAWIRA (PT) is a healthcare provider. based in Duluth, Georgia. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. PT012671 (GA). The NPI Number for RUDO ALICE TAKAWIRA (PT) is 1104331206

Main info

Female
24 Years Of Experience
Name
RUDO ALICE TAKAWIRA (PT)
NPI
1104331206
Phone
(214) 952-4605
Address
2376 BRANSLEY PL
Enumeration Date
11 December 2017
Last Update Date
29 March 2021

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8774073422
Graduation Year
2002 (24 years ago)
PAC ID
3173922556
Group Practice PAC ID
6800162298
Professional Enrollment ID
I20210604002796
Address ID
GA30097XXXXDUXXXXXXXXXX00
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience45
Completeness75
Years active:8State licenses:1Digital endpointsOther names

2,870 PHYSICAL THERAPIST IN PRIVATE PRACTICE in GA

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Provider Addresses for RUDO ALICE TAKAWIRA (PT)

  • 2376 BRANSLEY PL

    DULUTH, GA 300974336

    Phone: (214) 952-4605

    Type: Mailing

  • Cantrell Road, Flowery Branch, Hall County, Georgia, 30542, United States

    FLOWERY BRANCH, GA 305423304

    Phone: (770) 967-2070

    Type: Location

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: 2021-06-04

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20210604002796IPhysical Therapist In Private PracticeGATBD

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.

Verify on CMS Revalidation Lookup Tool

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 30097)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6800162298View full group profile
NameSpecialtyState
Occupational Therapist In Private PracticeNJ
Occupational Therapist In Private PracticeNJ
Qualified Speech Language PathologistWA
Physical Therapist In Private PracticeCT
Physical Therapist In Private PracticeGA
Occupational Therapist In Private PracticeNJ
Qualified Speech Language PathologistNC
Occupational Therapist In Private PracticeNJ
Qualified Speech Language PathologistNJ
Occupational Therapist In Private PracticeGA

Reviews

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Frequently asked questions

What identifier follows RUDO ALICE TAKAWIRA (PT) across health systems?
The NPI 1104331206 uniquely identifies RUDO ALICE TAKAWIRA (PT) in U.S. healthcare data.
Is RUDO ALICE TAKAWIRA (PT)'s NPI status active today?
Active status means RUDO ALICE TAKAWIRA (PT)'s NPI record is not deactivated in the public file.
What services align with RUDO ALICE TAKAWIRA (PT)'s listing?
RUDO ALICE TAKAWIRA (PT)'s public classification highlights Physical Therapist. Clinical services aligned with this taxonomy classification.
What city is tied to RUDO ALICE TAKAWIRA (PT)?
The directory associates RUDO ALICE TAKAWIRA (PT) with Duluth, Georgia. Check all listed addresses for suites or satellite offices.
What is the difference between NPI and a medical license?
An NPI is a federal identifier; a medical license is issued by a state and governs where someone may practice.

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