Cedar Grove Rehab LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

CEDAR GROVE REHAB LLC

Practice address

3395 Bouldercrest Rd
Ellenwood, GA 30294-1639

Phone

(404) 241-3280

NPI assigned

Apr 30, 2013

Last updated

Apr 30, 2013By 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

Mr. Otis L Bonner III

Title

Attorney

Phone

(770) 940-4975

Specialties & licenses 3

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.

• Charles Schmidt, DC

  • Chiropractor
  • Ellenwood, GA
  • NPI 1780794859
  NPD (past)

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

{
    "created_epoch": "1367280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1367280000000",
    "number": "1255776613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3395 BOULDERCREST RD",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302941639",
            "telephone_number": "404-241-3280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3395 BOULDERCREST RD",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302941639",
            "telephone_number": "404-241-3280"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CEDAR GROVE REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-04-30",
        "last_updated": "2013-04-30",
        "status": "A",
        "authorized_official_last_name": "BONNER",
        "authorized_official_first_name": "OTIS",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "ATTORNEY",
        "authorized_official_telephone_number": "770-940-4975",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Latonya Ann Cash, LPN
• Christian Kyle Casimir
• Cassandra R Stewart DDS MPH PA
• Grayson Cathy
• CDR Management Group, LLC (Fins Home Care)
• Alvin Cephas, CST/CFA
• Joe S. Chafin, DMD
• Nicole Chambers, RPH
• Lakesha M Chandler
• Deborah Shirley Charles-Baptiste

• Physical Medicine & Rehabilitation Physician in Ellenwood, GA
• Providers in Ellenwood, GA by specialty
• Physical Medicine & Rehabilitation Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 30, 2013; 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.