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

Nikita Gautam Shah

Individual provider Physical Therapist · NPI 1093059677

Nikita Gautam Shah is a Physical Therapist in Private Practice in Smyrna, Georgia. Qualified in 2010, 16 years ago. Practices with Independent Physical Therapy of Georgia LLC, a 529-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in New York.

Years since qualifying
16
Licensed in
NY
In the registry since
2012
Specialties on file
2
Claim this listing Report a problem Suggest an edit

Practice location Address checks out

4600 W Village Pl SE Ste 4007
Smyrna, GA 30080-9213
Phone: (770) 438-2015
Show map & directions

Directions in Google Maps · Apple Maps · OpenStreetMap

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 335 Court St, Brooklyn, NY 11231-4335 — (718) 855-1543

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X
Physical Therapist Taxonomy 225100000X · Licence 034601 (NY)

Record details

NPI number1093059677
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedNovember 20, 2012
Last updated in NPPESApril 10, 2024
Certification dateApril 10, 2024

Medicare enrollment

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

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Independent Physical Therapy Of Georgia Llc — 529 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Smyrna