OPTIMUM HEALTH REHAB OF WOODSTOCK LLC (NPI# 1578974390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578974390 |
| Entity Type | Organization |
| Organization Name | OPTIMUM HEALTH REHAB OF WOODSTOCK LLC |
| Other Organization Name | OPTIMUM HEALTH WOODSTOCK LLC |
| Practice Address |
2360 Towne Lake Pkwy Ste 104 Woodstock GA 30189-5576 |
| Mailing Address |
2133 Highway 317 Ste 12-318 Suwanee GA 30024-2649 |
| Practice Telephone | 7705167477 |
| Practice Fax Number | 7705167493 |
| Mailing Telephone | 6787306240 |
| Mailing Fax Number | 6787301943 |
| Enumeration Date | 2014-05-14 |
| 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 Woodstock LLC | Doing Business As Name - Organization |
| Street Address |
2360 TOWNE LAKE PKWY STE 104 |
| City | WOODSTOCK |
| State | GA |
| Zip Code | 30189-5576 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346880903 | Woodstock Eyesite Inc | Optometrist | 2360 Towne Lake Pkwy Ste 104, Woodstock, GA 30189-5576 | 2020-01-13 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801494356 | Susan Iruku | Pharmacist | 12050 Ga-92 #112, Woodstock, GA 30189 | 2020-10-15 |
| 1598267437 | Kelly Sierra | Nurse Practitioner | 100 Stoneforest Dr Ste 300, Woodstock, GA 30189 | 2018-03-07 |
| 1548770449 | Chandra Johnson | Nurse Practitioner | 295 Molly Lane Ste 150, Woodstock, GA 30189 | 2017-10-05 |
| 1083133912 | Amanda Bostock Sowisdral | Physician Assistant | 250 Parkbrooke Pl Ste 300, Woodstock, GA 30189 | 2017-09-12 |
| 1780101659 | Laura C Koch Woodstock LLC Dba Fountain View Dentistry | Dentist | 1816 Eagle Drive, Building 200-a, Woodstock, GA 30189 | 2017-08-23 |
| 1265954788 | Vicky Morton Bryan | Nurse Practitioner | 422 Sycamore Trail, Woodstock, GA 30189 | 2017-07-17 |
| 1063933588 | Marietta Eye Clinic, Pa | Optometrist | 2990 Eagle Dr Ste 110, Woodstock, GA 30189 | 2017-07-06 |
| 1275914749 | Nrup Tolat | Podiatrist | 100 Stoneforest Dr Ste 120, Woodstock, GA 30189 | 2015-06-10 |
| 1558781534 | Mary Jansson Carmon | Nurse Practitioner | 1000 Towne Lake Pkwy, Woodstock, GA 30189 | 2014-04-17 |
| 1518388941 | Afc Physicians of Georgia, PC | General Practice | 6440 Bells Ferry Rd, Woodstock, GA 30189 | 2014-01-03 |
| Find all providers in zip 30189 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518388941 | Afc Physicians of Georgia, PC | General Practice | 6440 Bells Ferry Rd, Woodstock, GA 30189 | 2014-01-03 |
| 1679726277 | Harry Daniel Watkins Jr. | General Practice | 225 Creekstone Rdg Ste 375, Woodstock, GA 30188 | 2008-10-28 |
| 1629168059 | William Shevin | General Practice | 50 Applewood Dr, Woodstock, CT 06281 | 2006-10-14 |
| 1083919419 | Leo A. Reyes, M.d.,p.c. | General Practice | 1664 S. Eastwood Drive, Woodstock, IL 60098-4655 | 2011-01-16 |
| 1750514295 | Eagle Drive Family Medicine PC | General Practice | 1816 Eagle Dr, Suite 200-b, Woodstock, GA 30189-8272 | 2009-09-01 |
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| 1477176394 | Optimal Choice Telehealth | General Practice | 1227 Rockbidge Rd Sw, Ste 208-354, Stone Mountain, GA 30087 | 2020-05-27 |
| 1053946004 | Proactive Medical Center | General Practice | 3455 Peachtree Industrial Blvd Ste 910, Duluth, GA 30096-6502 | 2020-03-10 |
| 1285265546 | Idea Body Institute Atlanta Asc | General Practice | 371 E Paces Ferry Rd Ne Ste 450, Atlanta, GA 30305-3292 | 2020-01-27 |
| 1730729849 | Summit Health Primary and Urgent Care LLC | General Practice | 120 Handley Rd Bldg 400 Ste #410, Tyrone, GA 30290-3029 | 2020-01-07 |
| 1770121030 | New Life Medical Centers Georgia LLC | General Practice | 3550 Lenox Rd Ne Ste 2100, Atlanta, GA 30326-1810 | 2019-12-18 |
| 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.