Southern Physical & Occupational Therapy Services, Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

PT004081 Issued in GA

Legal business name

SOUTHERN PHYSICAL & OCCUPATIONAL THERAPY SERVICES, INC

Practice address

305 Benjamin H Hill Dr W
Fitzgerald, GA 31750-8720

Phone

(229) 423-8403

Fax

(229) 423-8340

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Steven L Taylor, RPTNPI 1467426908

Title

President Owner

Phone

(229) 423-8403

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Steven Lee Taylor, PT

  • Physical Therapist
  • Fitzgerald, GA
  • NPI 1467426908

  GA, Physical Therapist

  Medicare reassignment Care Compare group NPD Authorized official
• Jennifer Frey, PT

  • Physical Therapist
  • Fitzgerald, GA
  • NPI 1922152685

  GA, Physical Therapist

  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1319587200000",
    "number": "1295847309",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "305 BENJAMIN H HILL DR W",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317508720",
            "telephone_number": "229-423-8403",
            "fax_number": "229-423-8340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 BENJAMIN H HILL DR W",
            "city": "FITZGERALD",
            "state": "GA",
            "postal_code": "317508720",
            "telephone_number": "229-423-8403",
            "fax_number": "229-423-8340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN PHYSICAL & OCCUPATIONAL THERAPY SERVICES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-10-26",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "PRESIDENT OWNER",
        "authorized_official_telephone_number": "229-423-8403",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": "GA",
            "license": "OT000451",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT004081",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000785144B",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• South Central Primary Care Center, Inc
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• South Georgia Mental Healthcare, LLC
• South Health District
• Southern Regional Mobile Healthcare Services, LLC
• Allison Allen Stapleton, PHARMD
• Suzanne Marie Stone
• Rebecca Tank
• Derrick W Taylor, MD

• All providers in Fitzgerald, GA
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.