Sovereign Rehabilitation of Georgia, LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

SOVEREIGN REHABILITATION OF GEORGIA, LLC

Doing business as

Centers for Orthopedic Rehab

Practice address

595 Hurricane Shoals Rd NW
Suite 100
Lawrenceville, GA 30045-4426

Phone

(678) 205-5420

Fax

(678) 205-5462

NPI assigned

Mar 25, 2008

Last updated

Jul 19, 2008By 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

Alan J Grodin

Title

President

Phone

(404) 835-3343

Specialties & licenses 1

Addresses

Other names 1

• CENTERS FOR ORTHOPEDIC REHAB Doing business as

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216425600000",
    "number": "1144492661",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 201",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421703",
            "telephone_number": "404-835-3343",
            "fax_number": "404-207-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "595 HURRICANE SHOALS RD NW",
            "address_2": "SUITE 100",
            "city": "LAWRENCEVILLE",
            "state": "GA",
            "postal_code": "300454426",
            "telephone_number": "678-205-5420",
            "fax_number": "678-205-5462"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN REHABILITATION OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2008-07-19",
        "status": "A",
        "authorized_official_last_name": "GRODIN",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-835-3343"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTERS FOR ORTHOPEDIC REHAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Southern Gastroenterology Associates, LLC
• Southern Sky Outpatient Detox, LLC (Georgia Sky Outpatient Detox, LLC)
• Southern Smiles Lawrenceville PC
• Southern Surgical Associates, PC
• Southside Medical Center, Inc
• Yacine N Sow, MD
• Emmanuel O Soyoola, M.D., PHD
• Vyacheslav Vladimirovich Sozonov, DNAP
• Jordan Spain
• Wesley Adam Spake, PT, DPT

• Physical Therapy Clinic/Center in Lawrenceville, GA
• Providers in Lawrenceville, GA by specialty
• Physical Therapy Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2008; 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.