ABDOURAHMAN JALLOW (DPT, PT) – Physical Therapist, NPI 1104649623

ABDOURAHMAN JALLOW (DPT, PT) is a healthcare provider. based in Clinton twp, Michigan. specializing in PHYSICAL THERAPIST IN PRIVATE PRACTICE. They hold the professional credentials DPT, PT. They hold a License No. 017466 (GA). The NPI Number for ABDOURAHMAN JALLOW (DPT, PT) is 1104649623

Main info

Male
2 Years Of Experience
Accepts Medicare Assignment
Name
ABDOURAHMAN JALLOW (DPT, PT)
NPI
1104649623
Phone
Not provided
Address
33900 HARPER AVE STE 104
Enumeration Date
4 November 2024
Last Update Date
3 December 2025

Doctor Profile

Medical School Name
EMORY UNIVERSITY SCHOOL OF MEDICINE
Secondary Phone
4047783350
Graduation Year
2024 (2 years ago)
PAC ID
5597292169
Group Practice PAC ID
1153382676
Professional Enrollment ID
I20241219003953
Address ID
GA303292315AT21XXXLNXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness85
Years active:1State licenses:1Digital endpointsOther names

2,870 PHYSICAL THERAPIST IN PRIVATE PRACTICE in GA

Provider Addresses for ABDOURAHMAN JALLOW (DPT, PT)

  • 33900 HARPER AVE STE 104

    CLINTON TWP, MI 480354258

    Phone:

    Type: Mailing

  • 115 SUMNER RD

    FAYETTEVILLE, GA 302144758

    Phone: (706) 407-4446

    Fax: (706) 845-9481

    Type: Location

  • 1867 Harvard Ave

    Atlanta, GA 303373526

    Phone: (404) 835-4321

    Fax: (404) 835-4320

    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: 2024-12-19

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
I20241219003953IPhysical 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 48035)

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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: 1153382676View full group profile
NameSpecialtyState
-GA
-TN
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeTN
-GA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA
Physical Therapist In Private PracticeGA

Reviews

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Frequently asked questions

Can I cross-check ABDOURAHMAN JALLOW (DPT, PT) using NPI 1104649623?
NPI 1104649623 belongs to ABDOURAHMAN JALLOW (DPT, PT); compare other details if you need extra assurance.
Would ABDOURAHMAN JALLOW (DPT, PT) appear as active to a payer?
You can treat ABDOURAHMAN JALLOW (DPT, PT) as active for directory purposes; confirm clinical privileges separately.
How would a patient describe ABDOURAHMAN JALLOW (DPT, PT)'s focus?
For ABDOURAHMAN JALLOW (DPT, PT), the primary taxonomy reads as Physical Therapist. Clinical services aligned with this taxonomy classification.
What practice footprint exists for ABDOURAHMAN JALLOW (DPT, PT)?
Travel planning: use Clinton Twp, Michigan as the reference point for ABDOURAHMAN JALLOW (DPT, PT), then confirm.
When was this NPI issued?
Enumeration for ABDOURAHMAN JALLOW (DPT, PT) is noted as November 4, 2024 where the registry provides it.

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