MEDICARE: CALI ANN PUSHEE PT, DPT

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	CP025105T	TN
2	225100000X	Physical Therapist	PT016756	GA
3	225100000X	Physical Therapist	CP026851T	VA
4	225100000X	Physical Therapist	CP052417T	AZ

General Provider Information

NPI Number	:	1598542839
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CALI ANN PUSHEE PT, DPT

Provider Business Mailing Address
First Line	:	5312 SCHOONER CT
Second Line	:
City	:	GAINESVILLE
State	:	GA
Zip	:	30504-8266
Country	:	US
Telephone Number	:	770-608-7812
Fax Number	:

Provider Business Practice Location Address
First Line	:	212 RETREAT VLG
Second Line	:
City	:	SAINT SIMONS ISLAND
State	:	GA
Zip	:	31522-2403
Country	:	US
Telephone Number	:	912-638-1444
Fax Number	:	912-638-0077

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/11/2023
Last Update Date	:	03/03/2026

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