Physical Rehab Medicine Specialists LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

067000 Issued in GA

Legal business name

PHYSICAL REHAB MEDICINE SPECIALISTS LLC

Practice address

2121 Fountain Dr
Ste D
Snellville, GA 30078-7023

Phone

(770) 674-4888

NPI assigned

May 28, 2013

Organization subpart

No

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

Authorized official

Name

Parchelle Connally, MD

Title

Owner

Phone

(770) 674-4888

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1369699200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1369699200000",
    "number": "1265879597",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 678037",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752678037"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 FOUNTAIN DR",
            "address_2": "STE D",
            "city": "SNELLVILLE",
            "state": "GA",
            "postal_code": "300787023",
            "telephone_number": "770-674-4888"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL REHAB MEDICINE SPECIALISTS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-05-28",
        "last_updated": "2013-05-28",
        "status": "A",
        "authorized_official_last_name": "CONNALLY",
        "authorized_official_first_name": "PARCHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-674-4888",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "067000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Snellville, GA
• Providers in Snellville, 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 May 28, 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.