OPTIMUM HEALTH REHAB OF LVILLE-GRAYSON LLC (NPI# 1164835591) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164835591 |
| Entity Type | Organization |
| Organization Name | OPTIMUM HEALTH REHAB OF LVILLE-GRAYSON LLC |
| Other Organization Name | OPTIMUM HEALTH GRAYSON LLC |
| Practice Address |
2445 Moon Rd Grayson GA 30017-1658 |
| Mailing Address |
2133 Highway 317 Ste 12-318 Suwanee GA 30024-2649 |
| Practice Telephone | 6789857286 |
| Practice Fax Number | 6789857287 |
| Mailing Telephone | 6789857286 |
| Mailing Fax Number | 6789857287 |
| Enumeration Date | 2014-06-03 |
| Last Update Date | 2016-04-11 |
| Authorized Official Name | MONICA SHELTON (PRACTICE MANAGER) |
| Authorized Official Telephone | 6787306240 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | Chiropractic Providers | ||
| N | 225100000X | Physical Therapist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
| Y | 208D00000X | General Practice | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Optimum Health Grayson LLC | Doing Business As Name - Organization |
| Street Address |
2445 MOON RD |
| City | GRAYSON |
| State | GA |
| Zip Code | 30017-1658 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538337464 | Optimum Health of L'ville-grayson | Chiropractor | 2445 Moon Rd, Grayson, GA 30017-7851 | 2008-02-13 |
| 1326598731 | Integrated Healthcare Center of Grayson LLC | Specialist | 2445 Moon Rd, Grayson, GA 30017-7851 | 2016-10-10 |
| 1295904894 | Jordan L Lunday | Chiropractor | 2445 Moon Rd, Grayson, GA 30017-7851 | 2008-02-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1588140859 | Butterfly Development, LLC | Community Based Residential Treatment Facility, Mental Illness | 1911 Grayson Highway, Suite 8-242, Grayson, GA 30017 | 2018-07-19 |
| 1811417132 | Yva Gauthier | Nurse Practitioner | 1620 Terry Mill Lane, Grayson, GA 30017 | 2017-06-27 |
| 1023341518 | Christine R Petro, Psy.d., LLC | Psychologist | 69 Grayson New Hope Rd, Grayson, GA 30017 | 2009-09-15 |
| 1902097579 | Zain Odeh Dabbas | Dentist | 2594 Loganviile Hwy, # 102, Grayson, GA 30017 | 2007-08-07 |
| 1619078276 | Primary Foot & Ankle Care | Podiatrist | 862 Amber Hill Ct, Grayson, GA 30017 | 2006-09-26 |
| 1700878170 | James Michael Long | Dentist | 2518 Loganville Hwy, Grayson, GA 30017 | 2005-08-22 |
| 1629556717 | Mason Moriah Earp | Physical Therapist | 2065 Grayson Hwy Ste B, Grayson, GA 30017 | 2018-08-01 |
| 1811482201 | Matthew Ntomoo Lo | Physical Therapy Assistant | 2065 Grayson Hwy Ste B, Grayson, GA 30017 | 2018-06-27 |
| 1144460668 | Alisa M Nelson-wade | Dentist | 2219 Loganville Hwy, Hwy 20, Grayson, GA 30017 | 2009-02-24 |
| 1003321662 | Grace Care Ambulance Transport, LLC | Ambulance | 516 Sosebee Farm Rd Unit 531, Grayson, GA 30017-0118 | 2017-12-05 |
| Find all providers in zip 30017 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
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| 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.