Central Ga Family Therapy

Primary specialty

Comprehensive Outpatient Rehabilitation Facility (CORF)Taxonomy code 261QR0401X

Legal business name

CENTRAL GA FAMILY THERAPY

Practice address

100 Hamilton Pointe Dr
Byron, GA 31008-6271

Phone

(478) 845-3520

Fax

(478) 621-7233

NPI assigned

Jun 3, 2024

Last updated

Jun 3, 2024By 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. Clarence HicksNPI 1356783245

Title

Owner

Phone

(478) 845-3520

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 5

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.

• Miranda White, DPT

  • Physical Therapist
  • Atlanta, GA
  • NPI 1386744233
  Medicare reassignment NPD
• Clarence Hicks

  • Case Management Agency
  • Byron, GA
  • NPI 1356783245
  NPD Authorized official
• Cynthia Dy

  • Physical Therapist
  • Byron, GA
  • NPI 1124420310
  NPD (past)
• Hannah Hilliard, COTA/L

  • Occupational Therapy Assistant
  • Byron, GA
  • NPI 1679003891
  NPD (past)
• Jennifer Wootson

  • Occupational Therapist
  • Byron, GA
  • NPI 1639509086
  NPD (past)

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717372800000",
    "number": "1316788540",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27393",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312217393",
            "telephone_number": "478-845-3520",
            "fax_number": "478-621-7233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HAMILTON POINTE DR",
            "city": "BYRON",
            "state": "GA",
            "postal_code": "310086271",
            "telephone_number": "478-845-3520",
            "fax_number": "478-621-7233"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4671 Mercer University Dr",
            "address_purpose": "LOCATION",
            "city": "Macon",
            "state": "GA",
            "postal_code": "312105611",
            "country_code": "US",
            "telephone_number": "478-845-3520",
            "fax_number": "478-956-0958",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CENTRAL GA FAMILY THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "CLARENCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-845-3520",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0401X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Comprehensive Outpatient Rehabilitation Facility (CORF)",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Careconnect Health, Inc. (Pediatric Convenient Care)
• Careconnect Health, Inc. (CareConnect Family Practice)
• Caring Hearts Companions & Caregivers
• Caring Med LLC
• CB Chiro, LLC
• Jamie Lilly Chamberlain, FNP
• Alexis D Chambliss, SPEECH-LANGUAGE
• Dae-Yong Pieter Chang, RRT
• Casey Cochran
• Connect Care Pharmacy, LLC (Connect Care Pharmacy)

• Comprehensive Outpatient Rehabilitation Facility (CORF) in Byron, GA
• Providers in Byron, GA by specialty
• Comprehensive Outpatient Rehabilitation Facility (CORF) in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; 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.