Active NPI
Activekidz and Adult Therapy Services
- Pediatric Rehabilitation Medicine Physician
- Tyrone, GA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Rehabilitation Medicine Physician
- Legal business name
- ACTIVEKIDZ AND ADULT THERAPY SERVICES
- Practice address
- 1130 Senoia Rd Ste A1
Tyrone, GA 30290-1640 - Phone
- (678) 632-6765
- NPI assigned
- Apr 25, 2024
- Last updated
- Apr 25, 2024
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Susan Gerald Cook
- Title
- Owner
- Phone
- (770) 207-6390
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Rehabilitation Medicine Physician | 2081P0010X | NU | Primary |
Addresses
Primary practice location
1130 Senoia Rd Ste A1
Tyrone, GA 30290-1640
Mailing address
1431 Capital Ave Ste 123
Watkinsville, GA 30677-1883
National Provider Directory
National Provider Directory- Tax ID family
- Activekidz and Adult Therapy Services
Other organizations with this tax ID 2
Organizations that report the same tax identification number in the National Provider Directory.
-
- Pediatric Rehabilitation Medicine Physician
- Calhoun, GA
- NPI 1194571760
-
- Pediatric Rehabilitation Medicine Physician
- Rome, GA
- NPI 1720834302
Locations
1130 Senoia Rd
Ste A1
Tyrone, GA 30290
Phone (678) 632-6765
Practitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Physical Therapist
- Monroe, GA
- NPI 1295775955
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1714003200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1714003200000",
"number": "1093561656",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1431 CAPITAL AVE STE 123",
"city": "WATKINSVILLE",
"state": "GA",
"postal_code": "306771883"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1130 SENOIA RD STE A1",
"city": "TYRONE",
"state": "GA",
"postal_code": "302901640",
"telephone_number": "678-632-6765"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ACTIVEKIDZ AND ADULT THERAPY SERVICES",
"organizational_subpart": "NO",
"enumeration_date": "2024-04-25",
"last_updated": "2024-04-25",
"certification_date": "2024-04-25",
"status": "A",
"authorized_official_last_name": "COOK",
"authorized_official_first_name": "SUSAN",
"authorized_official_middle_name": "GERALD",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "770-207-6390"
},
"taxonomies": [
{
"code": "2081P0010X",
"taxonomy_group": "",
"desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
"state": "NU",
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tyrone, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.