KIA DENAE MATTISON (NPI# 1023626116) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023626116 |
| Entity Type | Individual |
| Full Name | KIA DENAE MATTISON |
| Credential | PT |
| Practice Address |
12010 Etris Rd Ste A150 Roswell GA 30075-8009 |
| Mailing Address |
107 E Thistle Ln Greenville SC 29615-5538 |
| Practice Telephone | 7709989599 |
| Mailing Telephone | 8643296091 |
| Enumeration Date | 2020-07-15 |
| Last Update Date | 2020-07-15 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
12010 ETRIS RD STE A150 |
| City | ROSWELL |
| State | GA |
| Zip Code | 30075-8009 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760866388 | Angela Joy Lagambina | Speech-Language Pathologist | 12010 Etris Rd Ste A150, Roswell, GA 30075-8009 | 2015-07-14 |
| 1285252569 | Kelly Gatch | Speech-Language Pathologist | 12010 Etris Rd Ste A150, Roswell, GA 30075-8009 | 2020-07-13 |
| 1023656758 | Brittany Dolores Norman | Occupational Therapist | 12010 Etris Rd Ste A150, Roswell, GA 30075-8009 | 2019-12-12 |
| 1730731241 | Juliana White | Speech-Language Pathologist | 12010 Etris Rd Ste A150, Roswell, GA 30075-8009 | 2019-07-15 |
| 1326507930 | Cynthia Kim | Occupational Therapist | 12010 Etris Rd Ste A150, Roswell, GA 30075-8009 | 2019-03-14 |
| 1063998193 | Kathlyn Lesesne Bragg | Speech-Language Pathologist | 12010 Etris Rd Ste A150, Roswell, GA 30075-8009 | 2018-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851889539 | William Shelton Green | Specialist/Technologist | 1055 Riceland Ct, Roswell, GA 30075 | 2018-04-27 |
| 1043712524 | Lena Claire Morison | Music Therapist | 12060 Etris Rd. #200, Roswell, GA 30075 | 2018-03-01 |
| 1790232031 | Christina Danielle Dicioccio | Physician Assistant | 11040 Crabapple Rd # Suiea, Roswell, GA 30075 | 2016-09-02 |
| 1720531767 | Arbor Cove Therapy LLC | Social Worker | 981 Canton St, Suite 200-e, Roswell, GA 30075 | 2016-07-26 |
| 1740640887 | Christina C Plaice | Counselor | 10882 Crabapple Road, Suite 2, Roswell, GA 30075 | 2016-03-02 |
| 1215316435 | Jlm X-ray LLC | Portable X-ray and/or Other Portable Diagnostic Imaging Supplier | 1015 Canton Street, Roswell, GA 30075 | 2015-05-20 |
| 1174953624 | Ellen Terrell | Occupational Therapist | 10050 Crabapple Road, Suite D-115a, Roswell, GA 30075 | 2013-11-20 |
| 1114269974 | Patricia E Hernandez | Nurse Practitioner | 10479 Alpharetta St Ste 18, Roswell, GA 30075 | 2013-03-20 |
| 1750623658 | The George Center Foundation | Music Therapist | 1206 Etris Rd., Suite 200, Roswell, GA 30075 | 2013-03-19 |
| 1407187735 | Rachael Anne Templeton | Chiropractor | 593 Atlanta Street, Gorman Chiropractic, Roswell, GA 30075 | 2010-01-27 |
| Find all providers in zip 30075 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487027249 | Linda Weaver | Physical Therapist | 165 Dove Ct, Roswell, GA 30075-4393 | 2015-11-02 |
| 1710322706 | Big Gym Therapy, LLC | Physical Therapist | 325 Waverly Hall Cir, Roswell, GA 30075-2110 | 2013-05-03 |
| 1871818641 | Jacob's Ladder Neurodevelopmental Learning Center | Physical Therapist | 407 Hardscrabble Rd, Roswell, GA 30075-1417 | 2010-04-05 |
| 1720517881 | Martha Tucker Dickson | Physical Therapist | 11660 Alpharetta Hwy Ste 320, Roswell, GA 30076-3878 | 2017-06-12 |
| 1154791739 | Elizabeth Van Varick | Physical Therapist | 1000 Holcomb Woods Pkwy, Suite 422, Roswell, GA 30076-2575 | 2015-09-25 |
| 1043640287 | Carlyn N Harris | Physical Therapist | 11660 Alpharetta Hwy, Suite 320, Roswell, GA 30076-4943 | 2013-11-26 |
| 1760721179 | Peewee P.t., Inc. | Physical Therapist | 880 Marietta Hwy, Suite 630-310, Roswell, GA 30075-6755 | 2013-02-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598379794 | Building Pathways Therapy LLC | Physical Therapist | 2124 Cheshire Bridge Rd Ne Apt 2006, Atlanta, GA 30324-5731 | 2020-09-04 |
| 1679191464 | Pt Mamas, LLC | Physical Therapist | 5660 Lake Forrest Dr, Atlanta, GA 30342-4635 | 2020-07-08 |
| 1336764869 | Outside The Box Pediatric Therapy Solutions | Physical Therapist | 123 Talbot Rd, Savannah, GA 31410-4015 | 2020-06-10 |
| 1215557921 | Carly Cee Witt Gesite | Physical Therapist | 11785 Northfall Ln Ste 501&502, Alpharetta, GA 30009-7971 | 2020-04-22 |
| 1669009627 | Rebecca Grant | Physical Therapist | 5461 Meridian Mark Rd Ste 300, Atlanta, GA 30342-4014 | 2020-03-26 |
| 1508401704 | Danielle Anderson | Physical Therapist | 2146 Thompson Ave Se, Covington, GA 30014-2819 | 2019-11-12 |
| 1124677919 | Therapy Trails of Evans | Physical Therapist | 536 Grand Slam Dr Ste D, Evans, GA 30809-8045 | 2019-09-05 |
| 1043877459 | Hop, Skip & Jump Pediatric Physical Therapy LLC | Physical Therapist | 912 Milledge Rd, Augusta, GA 30904-4455 | 2019-05-21 |
| 1255894366 | Cicely Annette Watson | Physical Therapist | 2620 Satellite Blvd Ste 100, Duluth, GA 30096-1291 | 2019-04-08 |
| 1942772975 | Wee Care Pediatric Therapy, LLC | Physical Therapist | 335 Old Rail Rd, Bloomingdale, GA 31302-4025 | 2019-01-02 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.