Organization Active NPI

Synergy Rehab PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Marietta, GA
National Provider Identifier
1356100606
Registry record updated Feb 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
SYNERGY REHAB PC
Practice address
3225 Shallowford Rd Ste 500
Marietta, GA 30062-7024
Phone
(718) 534-0689
NPI assigned
Mar 18, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 20, 2025

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

Authorized official

Name
William RiversNPI 1639468580
Title
Owner
Phone
(478) 718-8747

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Internal Medicine) PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207RG0300X Primary

Addresses

Primary practice location

3225 Shallowford Rd Ste 500
Marietta, GA 30062-7024

Mailing address

4770 White Plains Rd
Bronx, NY 10470-1136

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240523003443 GA Part B Supplier - Clinic/Group Practice 1254773104 Receives reassigned benefits from 4 practitioners
Practice locations: Marietta, GA

National Provider Directory

National Provider Directory

Locations

3225 Shallowford Rd
Ste 500
Marietta, GA 30062
Phone (630) 504-0705

3225 Shallowford Rd
Ste 800
Marietta, GA 30062

Practitioners & affiliated clinicians

Practitioners 4

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": "1710720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740009600000",
    "number": "1356100606",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4770 WHITE PLAINS RD",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104701136"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 SHALLOWFORD RD STE 500",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300627024",
            "telephone_number": "718-534-0689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SYNERGY REHAB PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-03-18",
        "last_updated": "2025-02-20",
        "certification_date": "2025-02-20",
        "status": "A",
        "authorized_official_last_name": "RIVERS",
        "authorized_official_first_name": "WILLIAM",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "478-718-8747"
    },
    "taxonomies": [
        {
            "code": "207RG0300X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2025; 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.