JORDAN D MELLINGER (PT) – Physical Therapist, NPI 1669737771

JORDAN D MELLINGER (PT) is a healthcare provider. based in Augusta, Georgia. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials PT. They hold a License No. AT001719 (GA). The NPI Number for JORDAN D MELLINGER (PT) is 1669737771

Main info

Male
Sole Proprietor
14 Years Of Experience
Accepts Medicare Assignment
Name
JORDAN D MELLINGER (PT)
NPI
1669737771
Phone
(706) 724-6100
Address
1499 WALTON WAY
Enumeration Date
5 July 2012
Last Update Date
10 June 2024

Doctor Profile

Medical School Name
MEDICAL COLLEGE OF GEORGIA SCHOOL OF MEDICINE
Secondary Phone
2294830055
Graduation Year
2012 (14 years ago)
PAC ID
0648419036
Group Practice PAC ID
1355254780
Professional Enrollment ID
I20130614000458
Address ID
GA317637201LE117XXPKWY300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:13State licenses:1Digital endpointsOther names

2,870 PHYSICAL THERAPIST IN PRIVATE PRACTICE in GA

Provider Addresses for JORDAN D MELLINGER (PT)

  • 1499 WALTON WAY

    SUITE 1400

    AUGUSTA, GA 309012602

    Phone: (706) 724-6100

    Fax: (706) 724-1600

    Type: Mailing

  • 117 Oakland Pkwy

    Leesburg, GA 317637201

    Phone: (229) 483-0055

    Type: Location

  • PO BOX 370

    FORTSON, GA 318080370

    Phone: (706) 494-3071

    Type: Mailing

  • 1220 W WHEELER PKWY

    AUGUSTA, GA 309096625

    Phone: (706) 869-1515

    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: 2013-06-14

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
I20130614000458IPhysical 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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
97110Therapy procedure using exercise to develop strength, endurance, range of motion, and flexibility, each 15 minutes2,556159$0
97161Evaluation for physical therapy, typically 20 minutes141127$0
97530Therapy procedure using functional activities13634$0
97140Therapy procedure using manual technique, each 15 minutes7626$0
View full utilization report →

Insurance plans in this area (ZIP 30901)

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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: 1355254780View full group profile
NameSpecialtyState
-GA
-AL
Physical Therapist In Private PracticeGA
Physician AssistantAL
Physical Therapist In Private PracticeGA
Sports Medicine, Orthopedic Surgery, Orthopedic SurgeryGA
Nurse PractitionerGA
Physical Therapist In Private PracticeSC
Sports Medicine, Orthopedic SurgeryGA
Occupational Therapist In Private PracticeGA

Reviews

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Frequently asked questions

What number should I use to identify JORDAN D MELLINGER (PT) for billing?
Administrative and clinical systems typically use NPI 1669737771 for JORDAN D MELLINGER (PT).
Is JORDAN D MELLINGER (PT)'s NPI status active today?
Active status means JORDAN D MELLINGER (PT)'s NPI record is not deactivated in the public file.
How should patients interpret JORDAN D MELLINGER (PT)'s specialty?
The extract shows Physical Therapist for JORDAN D MELLINGER (PT). Clinical services aligned with this taxonomy classification.
Which community is linked to JORDAN D MELLINGER (PT)?
JORDAN D MELLINGER (PT) shows a connection to Augusta, Georgia in registry-derived data.
Who maintains JORDAN D MELLINGER (PT)'s record?
Providers certify NPPES data; CMS hosts the public file you are viewing.

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