SOVEREIGN REHABILITATION OF GEORGIA, LLC (NPI# 1144492661) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144492661 |
| Entity Type | Organization |
| Organization Name | SOVEREIGN REHABILITATION OF GEORGIA, LLC |
| Other Organization Name | CENTERS FOR ORTHOPEDIC REHAB |
| Practice Address |
595 Hurricane Shoals Rd Nw Suite 100 Lawrenceville GA 30045-4426 |
| Mailing Address |
5555 Peachtree Dunwoody Rd Ne Suite 201 Atlanta GA 30342-1703 |
| Practice Telephone | 6782055420 |
| Practice Fax Number | 6782055462 |
| Mailing Telephone | 4048353343 |
| Mailing Fax Number | 4042071391 |
| Enumeration Date | 2008-03-25 |
| Last Update Date | 2008-07-19 |
| Authorized Official Name | ALAN J GRODIN (PRESIDENT) |
| Authorized Official Telephone | 4048353343 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| CENTERS FOR ORTHOPEDIC REHAB | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215109749 | Sovereign Rehabilitation of Georgia, LLC | Clinic/Center | 3541 Highway 81, Loganville, GA 30052-4336 | 2008-03-25 |
| 1588836019 | Sovereign Rehabilitation of Georgia, LLC | Clinic/Center | 439 Sigman Rd Nw, Suite D, Conyers, GA 30012-3653 | 2008-03-25 |
| 1194267260 | Sovereign Rehabilitation of Georgia, LLC | Physical Therapist | 1301 Sigman Rd Ne, Suite 220, Conyers, GA 30012-3812 | 2016-11-07 |
| 1326210840 | Sovereign Rehabilitation of Georgia, LLC | Clinic/Center | 495 Winn Way, Suite 120, Decatur, GA 30030-1736 | 2008-03-25 |
| 1407028921 | Sovereign Rehabilitation of Georgia, LLC | Occupational Therapist | 3280 Howell Mill Rd Nw, Suite 345, Atlanta, GA 30327-4111 | 2008-03-25 |
| 1376756197 | Sovereign Rehabilitation of Georgia, LLC | Occupational Therapist | 5555 Peachtree Dunwoody Rd Ne, Suite 201, Atlanta, GA 30342-1703 | 2007-05-08 |
| Street Address |
595 HURRICANE SHOALS RD NW SUITE 100 |
| City | LAWRENCEVILLE |
| State | GA |
| Zip Code | 30045-4426 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1487619045 | Jayanti Jasti | Internal Medicine | 595 Hurricane Shoals Rd Nw, Suite 100, Lawrenceville, GA 30046 | 2006-04-18 |
| 1053950246 | Gregory Wilkerson | Nurse Practitioner | 595 Hurricane Shoals Rd Nw, Lawrenceville, GA 30046-8761 | 2020-01-05 |
| 1487168605 | Stephanie Jones | Nurse Practitioner | 595 Hurricane Shoals Rd Nw, Suite 300, Lawrenceville, GA 30046 | 2017-11-27 |
| 1447614656 | Rachel Elizabeth Gillman | Pediatrics | 595 Hurricane Shoals Rd Nw, Suite 300, Lawrenceville, GA 30046 | 2016-04-13 |
| 1922467943 | Jennifer Kahn Finney | Nurse Practitioner | 595 Hurricane Shoals Rd Nw, Suite 100, Lawrenceville, GA 30046 | 2016-02-18 |
| 1679964894 | Fms Lawrenceville, LLC | Clinic/Center | 595 Hurricane Shoals Rd Nw, Suite 202, Lawrenceville, GA 30046-8761 | 2015-02-10 |
| 1609132851 | Katayun Taasoobshirazi | Pediatrics | 595 Hurricane Shoals Rd Nw, Suite 300, Lawrenceville, GA 30046 | 2012-04-02 |
| 1003197310 | Brian Joseph Maloney | Physical Therapist | 595 Hurricane Shoals Rd Nw, Lawrenceville, GA 30046-8761 | 2011-08-31 |
| 1760773022 | Alana Meryll Bozeman | Pediatrics | 595 Hurricane Shoals Rd Nw, Suite 300, Lawrenceville, GA 30046 | 2011-04-21 |
| 1669782389 | Dale Harrison Alderman | Physical Therapist | 595 Hurricane Shoals Rd Nw, Suite 100, Lawrenceville, GA 30046 | 2010-10-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285104315 | Shalanda Monique Booker | Counselor | 2940 Emerald Springs Drive, Lawrenceville, GA 30045 | 2018-12-02 |
| 1669957320 | Chantelle S Fuller | Behavioral Analyst | 805 Donington Cir, Lawrenceville, GA 30045 | 2018-09-28 |
| 1356836035 | Gad Health Care LLC | Home Health | 1140 Great Oaks Dr, Lawrenceville, GA 30045 | 2018-06-26 |
| 1346668662 | Eca Optical, LLC | Eyewear Supplier (Equipment, not the service) | 601-a Professional Drive, Ste 170, Lawrenceville, GA 30045 | 2014-04-03 |
| 1598102733 | Selena Fuller | Nurse Practitioner | 181 South Clayton Street, Lawrenceville, GA 30045 | 2013-05-29 |
| 1942555982 | Vida Michele James-bryant | Community Health Worker | 1309 Avington Glen Dr, Lawrenceville, GA 30045 | 2012-07-16 |
| 1770840639 | Rebecca Vinson D'angelo | Occupational Therapist | 1518 Great Shoals Cir, Lawrenceville, GA 30045 | 2012-04-17 |
| 1427346774 | Amanda Michelel Woods | Psychologist | 285 South Perry Street, Lawrenceville, GA 30045 | 2011-07-20 |
| 1790070563 | M & G Pharmacy Inc | Pharmacy | 100 Hurricane Shoals Rd Suite F, Lawrenceville, GA 30045 | 2011-06-09 |
| 1306146154 | Thanh Dau | Optometrist | 1250 Scenic Highway, Ste 1268, Lawrenceville, GA 30045 | 2010-10-27 |
| Find all providers in zip 30045 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285243824 | Bryan Carestia, Pt, Dpt, Cscs | Clinic/Center | 26 Tamar Ct, Lawrenceville, NJ 08648-1582 | 2020-07-29 |
| 1942853916 | Core Care Women's & Children's Wellness Physical Therapy, LLC | Clinic/Center | 1585 Old Norcross Rd Ste 207b, Lawrenceville, GA 30046-4043 | 2019-07-18 |
| 1073522538 | Concentra Health Services, Inc. | Clinic/Center | 755 Lawrenceville Suwanee Rd, Suite 1600, Lawrenceville, GA 30043-7345 | 2006-08-05 |
| 1962981761 | Occupational Health Centers of New Jersey, P.a. | Clinic/Center | 2542 Brunswick Pike, Lawrenceville, NJ 08648 | 2018-08-13 |
| 1356845374 | Jmm Health Solutions, LLC | Clinic/Center | 480 Congress Pkwy, Lawrenceville, GA 30044-4579 | 2018-03-23 |
| 1912409046 | Grand Therapeutic Services LLC | Clinic/Center | 1600 Atkinson Rd Ste 111, Lawrenceville, GA 30043-5747 | 2018-03-05 |
| 1861921363 | Rachel Christie | Clinic/Center | 545 Old Norcross Rd Ste 100, Lawrenceville, GA 30046-3390 | 2017-06-08 |
| 1922379189 | 1source Fitness & Sports-neuro Rehab LLC | Clinic/Center | 1670 Mckendree Church Rd Ste 40, Lawrenceville, GA 30043-4100 | 2012-01-19 |
| 1972832772 | Elite Wellness Inc | Clinic/Center | 3315 Sugarloaf Pkwy, Suite 5, Lawrenceville, GA 30044-5497 | 2009-12-08 |
| 1487819330 | Concentra Health Services, Inc. | Clinic/Center | 860 Duluth Hwy, Suite 1600, Lawrenceville, GA 30043-5326 | 2008-07-21 |
| Find all providers in LAWRENCEVILLE | ||||
| City | LAWRENCEVILLE |
| Zip Code | 30045 |
Please comment or provide details below to improve the information on SOVEREIGN REHABILITATION OF GEORGIA, LLC.
| 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.