Sovereign Rehabilitation of Georgia, LLC

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT008054 Issued in GA

Legal business name

SOVEREIGN REHABILITATION OF GEORGIA, LLC

Practice address

1301 Sigman Rd NE
Suite 220
Conyers, GA 30012-3812

Phone

(678) 210-0311

Fax

(678) 210-0335

NPI assigned

Nov 7, 2016

Organization subpart

No

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

Authorized official

Name

Colette Johnson

Title

VP of Operations

Phone

(404) 680-6470

Specialties & licenses 1

Addresses

Tax ID family

Centerns for Orthopedic Rehab5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

• Centers for Orhtopedic Rehabilitation

  • Physical Therapy Clinic/Center
  • Atlanta, GA
  • NPI 1245427236
  NPD tax ID
• Centers for Orthopedic Rehabilitation

  • Physical Therapy Clinic/Center
  • Atlanta, GA
  • NPI 1588852263
  NPD tax ID
• Cor II

  • Physical Therapy Clinic/Center
  • Cumming, GA
  • NPI 1033381561
  NPD tax ID
• Cor II

  • Physical Therapy Clinic/Center
  • Atlanta, GA
  • NPI 1689845729
  NPD tax ID

Locations

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

{
    "created_epoch": "1478476800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1478476800000",
    "number": "1194267260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1301 SIGMAN RD NE",
            "address_2": "SUITE 220",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123812",
            "telephone_number": "678-210-0311",
            "fax_number": "678-210-0335"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 SIGMAN RD NE",
            "address_2": "SUITE 220",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123812",
            "telephone_number": "678-210-0311",
            "fax_number": "678-210-0335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN REHABILITATION OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-11-07",
        "last_updated": "2016-11-07",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "COLETTE",
        "authorized_official_title_or_position": "VP OF OPERATIONS",
        "authorized_official_telephone_number": "404-680-6470"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT008054",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Sovereign Rehabilitation of Georgia, LLC
• Yemi Joke Sowemimo, FNP
• Speech Language and Cognitive Rehabilitation LLC
• Quanta R Speight
• Spelios and Associates Conyers PC

• Physical Therapist in Conyers, GA
• Providers in Conyers, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 7, 2016; 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.