MR. JEDD ALAN THORDERSON (PT) – Clinical Electrophysiology Physical Therapist, NPI 1972790822
Clinical Electrophysiology Physical Therapist
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
769 PHYSICAL THERAPIST IN PRIVATE PRACTICE in MS
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Provider Addresses for MR. JEDD ALAN THORDERSON (PT)
44, Danielwood Drive, Town of Colonie, Albany County, New York, 12211, United States
206 B OXFORD ROAD
NEW ALBANY, MS 386520044
Phone: (662) 534-4445
Fax: (662) 534-9449
Type: Mailing
Tupelo Road, Edgewood Meadows, Edgewood, Harford County, Maryland, 21040, United States
SUITE 102
TUPELO, MS 388049791
Phone: (662) 680-3200
Fax: (662) 680-5090
Type: Location
3437 Tupelo Commons
Suite 102
Tupelo, MS 388049791
Phone: (662) 680-3200
Fax: (662) 680-5090
Type: Location
110 Professional Ct
Jesup, GA 315450044
Phone: (912) 427-0800
Type: Location
4340 KINGS WAY
VALDOSTA, GA 316026921
Phone: (229) 333-9736
Type: Location
PO BOX 370
FORTSON, GA 318080370
Phone: (706) 494-3171
Type: Mailing
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: 2024-11-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 3 Medicare enrollment records; no due dates published yet.
Enrollment records
3
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 |
|---|---|---|---|---|
| I20040512001242 | I | Physical Therapist In Private Practice | GA | TBD |
| I20240925002754 | I | Physical Therapist In Private Practice | FL | TBD |
| I20241105003956 | I | Physical Therapist In Private Practice | AL | 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 38652)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| - | GA | |
| - | AL | |
| Physical Therapist In Private Practice | GA | |
| Physician Assistant | AL | |
| Physical Therapist In Private Practice | GA | |
| Sports Medicine, Orthopedic Surgery, Orthopedic Surgery | GA | |
| Nurse Practitioner | GA | |
| Physical Therapist In Private Practice | SC | |
| Sports Medicine, Orthopedic Surgery | GA | |
| Occupational Therapist In Private Practice | GA |
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