Physical Therapy Pros – Clinical Electrophysiology Physical Therapist, NPI 1477998003
Clinical Electrophysiology Physical Therapist
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Physical Therapy Pros
2900 Chamblee Tucker Rd Bldg 3
Atlanta, GA 303414100
Phone: (678) 753-4364
Fax: (678) 736-4329
Type: Location
1790 SUMMIT EDGE CIR
LOGANVILLE, GA 300525343
Phone: (678) 753-4364
Fax: (470) 448-1133
Type: Mailing
PO BOX 1566
SNELLVILLE, GA 300781566
Phone: (678) 753-4364
Fax: (678) 736-4329
Type: Mailing
3885 Princeton Lakes Way SW Ste 306
Atlanta, GA 303317100
Phone: (678) 753-4364
Fax: (678) 736-4329
Type: Location
1741 Newnan Crossing Blvd E Ste G
Newnan, GA 302656601
Phone: (678) 753-4364
Fax: (678) 736-4329
Type: Location
3929 Carter Rd Bldg C
Buford, GA 305181628
Phone: (678) 753-4364
Fax: (678) 736-4329
Type: Location
2336 WISTERIA DR STE 420
SNELLVILLE, GA 300786160
Phone: (678) 753-4364
Fax: (678) 736-4329
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: 2025-05-28
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20250528001931 | O | Physical/Occupational Therapy Group In Private Practice | GA | 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 30341)
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