NPIMap

Organization Active NPI

Southern Therapy Services, Inc.

  • Rehabilitation Clinic/Center
  • Carrollton, GA
National Provider Identifier
1114981669
Registry record updated Sep 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
SOUTHERN THERAPY SERVICES, INC.
Practice address
812 S Park St
Carrollton, GA 30117-4412
Phone
(770) 834-7436
Fax
(770) 830-5954
NPI assigned
Apr 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 29, 2009

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

Authorized official

Name
George Bo Hamil Jr., PTNPI 1174587620
Title
Ceo/President
Phone
(770) 832-2484

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)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

812 S Park St
Carrollton, GA 30117-4412

Mailing address

120 E Center St
Carrollton, GA 30117-3303
Phone (770) 832-2484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040723000452 GA Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 2668452251 Practice locations: Carrollton, GA; Villa Rica, GA; Bremen, GA

National Provider Directory

National Provider Directory
Tax ID family
Southern Therapy Servic3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

Locations

300 Alabama Ave S
Ste A
Bremen, GA 30110
Phone (770) 537-6477

120 E Center St
Carrollton, GA 30117

214 Maple St
Villa Rica, GA 30180
Phone (770) 459-4555

690 Dallas Hwy
Ste 203
Villa Rica, GA 30180
Phone (770) 459-4550

Ownership & related parties

Subparts reporting this organization as parent 3

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1144886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1254182400000",
    "number": "1114981669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E CENTER ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173303",
            "telephone_number": "770-832-2484",
            "fax_number": "770-830-5961"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "812 S PARK ST",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301174412",
            "telephone_number": "770-834-7436",
            "fax_number": "770-830-5954"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN THERAPY SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-13",
        "last_updated": "2009-09-29",
        "status": "A",
        "authorized_official_last_name": "HAMIL",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "BO",
        "authorized_official_title_or_position": "CEO/PRESIDENT",
        "authorized_official_telephone_number": "770-832-2484",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carrollton, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.