NPIMap

Organization Active NPI

Sovereign Rehabilitation of Georgia, LLC

  • Physical Therapy Clinic/Center
  • Decatur, GA
National Provider Identifier
1326210840
Registry record updated Sep 15, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SOVEREIGN REHABILITATION OF GEORGIA, LLC
Practice address
495 Winn Way
Suite 120
Decatur, GA 30030-1736
Phone
(404) 389-0077
Fax
(404) 389-0082
NPI assigned
Mar 25, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 15, 2008

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

Authorized official

Name
Alan J Grodin
Title
President
Phone
(404) 835-3343

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

495 Winn Way
Suite 120
Decatur, GA 30030-1736

Mailing address

5555 Peachtree Dunwoody Rd NE
Suite 201
Atlanta, GA 30342-1703
Phone (404) 835-3343

Other names 1

  • CENTERS FOR ORTHOPEDIC REHAB Doing business as

National Provider Directory

National Provider Directory

Locations

470 Northside Cherokee Blvd
Ste 190
Canton, GA 30115
Phone (678) 880-6499

3411 Pierce Dr NE
Ste 200
Chamblee, GA 30341
Phone (770) 452-2955

5553 Peachtree Rd
Ste 200
Chamblee, GA 30341
Phone (770) 687-2161

1288 Wellbrook Cir NE
Ste A
Conyers, GA 30012
Phone (678) 369-6934

4114 Mill St NE
Ste B
Covington, GA 30014
Phone (678) 712-6282

575 Professional Dr
Ste 370
Lawrenceville, GA 30046
Phone (678) 205-5420

595 Hurricane Shoals Rd NW
Ste 100
Lawrenceville, GA 30046
Phone (404) 645-7150

3541 Highway 81
Loganville, GA 30052
Phone (678) 495-2990

5555 Peachtree Dunwoody Rd
Ste 225
Sandy Springs, GA 30342
Phone (404) 835-3340

Practitioners & affiliated clinicians

Practitioners 12

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

NPI Registry JSON

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

{
    "created_epoch": "1206403200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221436800000",
    "number": "1326210840",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5555 PEACHTREE DUNWOODY RD NE",
            "address_2": "SUITE 201",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303421703",
            "telephone_number": "404-835-3343",
            "fax_number": "404-207-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "495 WINN WAY",
            "address_2": "SUITE 120",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301736",
            "telephone_number": "404-389-0077",
            "fax_number": "404-389-0082"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOVEREIGN REHABILITATION OF GEORGIA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-03-25",
        "last_updated": "2008-09-15",
        "status": "A",
        "authorized_official_last_name": "GRODIN",
        "authorized_official_first_name": "ALAN",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-835-3343"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CENTERS FOR ORTHOPEDIC REHAB",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Decatur, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; 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.