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Organization Active NPI

Archbold Physical Medicine and Rehab of South Georgia

  • Physical Medicine & Rehabilitation Physician
  • Thomasville, GA
National Provider Identifier
1063856243
Registry record updated Jul 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
041159 Issued in GA
Legal business name
ARCHBOLD PHYSICAL MEDICINE AND REHAB OF SOUTH GEORGIA
Practice address
334 Smith Ave
Thomasville, GA 31792-5533
Phone
(229) 226-9412
Fax
(229) 226-4492
NPI assigned
Apr 18, 2013
Last updated
Jul 9, 2014By the provider in NPPES
Organization subpart
Yes
Parent organization
ARCHBOLD MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 9, 2014

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

Authorized official

Name
Mr. Charles Hightower
Title
Cfo
Phone
(229) 228-2853

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 041159 GA Primary

Addresses

Primary practice location

334 Smith Ave
Thomasville, GA 31792-5533

Mailing address

900 Cairo Rd
Thomasville, GA 31792-4255
Phone (229) 227-5158

National Provider Directory

National Provider Directory
Tax ID family
Archbold Medical Group Inc14 organizations share this tax ID, including this one
Part of
Archbold Medical Group Inc

Other organizations with this tax ID 13

Organizations that report the same tax identification number in the National Provider Directory.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1366243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1404864000000",
    "number": "1063856243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "900 CAIRO RD",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317924255",
            "telephone_number": "229-227-5158",
            "fax_number": "229-227-5187"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 SMITH AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317925533",
            "telephone_number": "229-226-9412",
            "fax_number": "229-226-4492"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ARCHBOLD PHYSICAL MEDICINE AND REHAB OF SOUTH GEORGIA",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "ARCHBOLD MEDICAL GROUP",
        "enumeration_date": "2013-04-18",
        "last_updated": "2014-07-09",
        "status": "A",
        "authorized_official_last_name": "HIGHTOWER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "229-228-2853",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "041159",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2014; 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.