Southern Therapy Associates

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

SOUTHERN THERAPY ASSOCIATES

Practice address

19350 Hartford St
Edison, GA 39846-5617

Phone

(229) 359-0741

Fax

(229) 835-2119

NPI assigned

Dec 13, 2012

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Tasha S West, COTA/L

Title

Cota/L Owner

Phone

(229) 359-0741

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1355356800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1355356800000",
    "number": "1013253376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 746",
            "city": "EDISON",
            "state": "GA",
            "postal_code": "398460746",
            "telephone_number": "229-359-0741",
            "fax_number": "229-835-2119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19350 HARTFORD ST",
            "city": "EDISON",
            "state": "GA",
            "postal_code": "398465617",
            "telephone_number": "229-359-0741",
            "fax_number": "229-835-2119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN THERAPY ASSOCIATES",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-12-13",
        "last_updated": "2012-12-13",
        "status": "A",
        "authorized_official_last_name": "WEST",
        "authorized_official_first_name": "TASHA",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "COTA/L  OWNER",
        "authorized_official_telephone_number": "229-359-0741",
        "authorized_official_credential": "COTA/L"
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Jessica Glass, FNP-C
• Stephanie Theresa James, LMSW
• Jarrell Alan Ray, RPH
• Gashebal Nicole Robinson, NP
• Tracy Alissa Rosenbaum, DO
• The Hospital Authority of Miller County
• The Hospital Authority of Miller County
• Willowood of Edison, Inc

• All providers in Edison, GA
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.