CMP Impact Therapeutic Services

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

CMP IMPACT THERAPEUTIC SERVICES

Practice address

1906 Elberta Rd Ste C
Warner Robins, GA 31093-1391

Phone

(478) 225-6404

NPI assigned

Jul 17, 2019

Last updated

Jul 17, 2019By 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

Coranne Polk, CPC

Title

Ceo

Phone

(478) 225-6404

Specialties & licenses 1

Addresses

Locations

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.

• Charlene Rogers, RN

  • Registered Nurse
  • Warner Robins, GA
  • NPI 1093368102
  NPD

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

{
    "created_epoch": "1563321600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1563321600000",
    "number": "1134772247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1906 ELBERTA RD STE C",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310931391",
            "telephone_number": "478-225-6404"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1906 ELBERTA RD STE C",
            "city": "WARNER ROBINS",
            "state": "GA",
            "postal_code": "310931391",
            "telephone_number": "478-225-6404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CMP IMPACT THERAPEUTIC SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-07-17",
        "last_updated": "2019-07-17",
        "status": "A",
        "authorized_official_last_name": "POLK",
        "authorized_official_first_name": "CORANNE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "478-225-6404",
        "authorized_official_credential": "CPC"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Antonio Cliett
• Shamika Latasha Clinton, PHARMD
• CLM Transportation LLC.
• Jukhari Clowers
• CMP Academy & Billing Service
• Jaekea Coar, NP
• Chani E Cochran, LCSW
• Jeffrey N. Cofie
• Veronica Cohen
• Vontreia Colbert, PHYSICAL THERAPIST

• Multi-Specialty Clinic/Center in Warner Robins, GA
• Providers in Warner Robins, GA by specialty
• Multi-Specialty Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2019; 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.