Rehab of Suwanee

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT007889 Issued in GA

Legal business name

REHAB OF SUWANEE

Practice address

1500 Peachtree Industrial Blvd
Suite #290
Suwanee, GA 30024

Phone

(770) 850-0857

NPI assigned

Apr 3, 2007

Last updated

Aug 22, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Daniel Lynn Middleton

Title

Billing Manager

Phone

(770) 850-0857

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1175558400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033230370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 671821",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300061821"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 PEACHTREE INDUSTRIAL BLVD",
            "address_2": "SUITE #290",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "30024",
            "telephone_number": "770-850-0857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHAB OF SUWANEE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-03",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "MIDDLETON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "BILLING MANAGER",
        "authorized_official_telephone_number": "770-850-0857",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT007889",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Suwanee, GA
• Providers in Suwanee, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.