Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Kevin Dat Van, DPT

Individual provider Physical Therapist · NPI 1770450124

Kevin Dat Van, DPT is a Physical Therapist in Private Practice in Roswell, Georgia. Qualified in 2025, 1 year ago. Practices with Southeast Rehabilitation Group Inc, a 6-clinician group and accepts Medicare assignment. Licensed in Georgia and Virginia.

Years since qualifying
1
Licensed in
GA, VA
In the registry since
2025
Specialties on file
2
What do these letters mean?
DPT — Doctor of Physical Therapy
The doctoral degree now required to enter physical therapy practice.

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Practice location Address checks out

875 Mansell Rd Ste H
Roswell, GA 30076-4800
Phone: (678) 821-2170
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence CP050485T (GA)
Physical Therapist Taxonomy 225100000X · Licence 2305217444 (VA)

Record details

NPI number1770450124
Entity typeIndividual (Type 1)
GenderMale
Credentials DPT
Sole proprietorNo
NPI enumeratedOctober 21, 2025
Last updated in NPPESNovember 3, 2025
Certification dateNovember 3, 2025
Mailing address875 Mansell Rd Ste H, Roswell, GA 30076-4800

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Southeast Rehabilitation Group Inc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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