MATRIX REHABILITATION - GEORGIA, INC. (NPI# 1518164102) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1518164102 |
| Entity Type | Organization |
| Organization Name | MATRIX REHABILITATION - GEORGIA, INC. |
| Other Organization Name | PROGRESSIVE SPORTS MEDICINE |
| Practice Address |
5223 Highway 278 Ne Covington GA 30014-2671 |
| Mailing Address |
665 Philadelphia St Indiana PA 15701-3941 |
| Practice Telephone | 7707849932 |
| Practice Fax Number | 7707849952 |
| Mailing Telephone | 7244653496 |
| Mailing Fax Number | 7244653726 |
| Enumeration Date | 2007-06-28 |
| Last Update Date | 2008-06-23 |
| Authorized Official Name | MR. DENNIS FITZPATRICK (CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 6106447824 |
| 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 |
|---|---|
| Progressive Sports Medicine | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942231378 | Matrix Rehabilitation - Georgia, Inc. | Clinic/Center | 4325 Atlanta Hwy, Suite 15, Loganville, GA 30052-3264 | 2006-07-05 |
| Street Address |
5223 HIGHWAY 278 NE |
| City | COVINGTON |
| State | GA |
| Zip Code | 30014-2671 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801495635 | Cathy Cassandra Collins | Pharmacist | 3639 Hwy 278, Covington, GA 30014 | 2020-10-22 |
| 1154933877 | Atl Optical LLC | Optometrist | 3135 Highway 278 Ne, Covington, GA 30014 | 2020-08-24 |
| 1932737046 | Samagas House Org | Adult Companion | 1500 Mountain View Cirlcle, Conyers, GA 30014 | 2020-04-01 |
| 1356834360 | Covington Dental Care | Dentist | 4139 Baker Street, Suite 15, Covington, GA 30014 | 2018-06-13 |
| 1487190005 | New Avenues Assessment and Counseling Center LLC | Counselor | 3192 Spring Street, Covington, NEWTON 30014 | 2017-01-07 |
| 1275903973 | Jennifer Carol Bridges | Registered Nurse | 320 Malcom Lane, Covington, GA 30014 | 2015-10-07 |
| 1134598501 | Shelby Boggus King | Physician Assistant | 4181 Hospital Drive Ne, Suite 204, Covington, GA 30014 | 2015-09-16 |
| 1366829814 | Wendy Pazdur | Counselor | 5109 Hwy 278 East, Suite D, Covington, GA 30014 | 2015-05-05 |
| 1306235445 | Covington Center for Family Dentistry | Dentist | 10373 Industrial Blvd, Covington, GA 30014 | 2015-01-13 |
| 1992103428 | Modern Cosmetic Dental Care, LLC | Clinic/Center | 1750 Highway 11, Suite B, Covington, GA 30014 | 2014-12-16 |
| Find all providers in zip 30014 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447851878 | Geaux Fight Rehabilitation Services, LLC | Clinic/Center | 424 W 15th Ave, Covington, LA 70433-3310 | 2020-11-03 |
| 1821355991 | Therapeutic Maxipotent | Clinic/Center | 13015 Brown Bridge Rd Ste 210, Covington, GA 30016-9110 | 2012-04-13 |
| 1407126733 | Guidry Physical Therapy Services LLC | Clinic/Center | 70493 Highway 21 Ste 600, Covington, LA 70433-7016 | 2012-01-03 |
| 1942320627 | Wheelchair & Mobility Clinic, LLC | Clinic/Center | 111 E 19th St, Covington, KY 41014-1201 | 2007-03-29 |
| 1740347368 | Covington Physical Therapy Center | Clinic/Center | 129 Corporate Drive, Covington, LA 70433-1057 | 2007-01-02 |
| 1326153479 | Georgia Rehab Services, Inc. | Clinic/Center | 5109 Highway 278 Ne, Suite # C, Covington, GA 30014-2608 | 2006-08-20 |
| 1225649858 | Advantage Therapy and Rehabilitation LLC | Clinic/Center | 506 4th St, Covington, IN 47932-1127 | 2020-08-17 |
| 1396381505 | Moving Mountains Pediatric Therapy | Clinic/Center | 2146 Thompson Ave Se, Covington, GA 30014-2819 | 2019-11-22 |
| 1174164388 | Norman Farms LLC | Clinic/Center | 4220 Gauntt Rd, Covington, GA 30014-0600 | 2019-09-30 |
| 1447716980 | Derek Paul Bornhorst | Clinic/Center | 401 E 20th St, Covington, KY 41014-1583 | 2019-02-20 |
| Find all providers in COVINGTON | ||||
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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.