Organization Active NPI

Rehab Engineering LLC

  • Prosthetic/Orthotic Supplier
  • Thomasville, GA
National Provider Identifier
1356598478
Registry record updated Jun 3, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetic/Orthotic SupplierTaxonomy code 335E00000X
License
14 Issued in GA
Legal business name
REHAB ENGINEERING LLC
Practice address
311 N Dawson St
Thomasville, GA 31792-5132
Phone
(877) 815-6557
Fax
(850) 656-6483
NPI assigned
Aug 20, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 3, 2014

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

Authorized official

Name
Jeffrey Ryan Fredrick, CPO
Title
Owner
Phone
(850) 656-3599

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetic/Orthotic Supplier 335E00000X 14 GA Primary

Addresses

Primary practice location

311 N Dawson St
Thomasville, GA 31792-5132

Mailing address

1719 Mahan Dr
Tallahassee, FL 32308-5201
Phone (850) 656-3599

Other identifiers 1

IdentifierTypeStateIssuer
746347392AMedicaidGA

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130816000432 GA DME Supplier - Orthotic PersonnelDME Supplier - Prosthetic Personnel 3173727427 Practice locations: Thomasville, GA

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

SupplierSuppliesMedicare assignment
Rehab Engineering LLC311 N Dawson St, Thomasville, GA 31792-5132(877) 815-6557 Orthoses: Custom Fabricated|Orthoses: Prefabricated (Non-Custom Fabricated)|Orthoses: Off-The-Shelf|Limb Prostheses|Diabetic Shoes and Inserts|Diabetic Shoes/Inserts - Custom Does not accept assignmentParticipating since Jul 20, 2007

National Provider Directory

National Provider Directory
Tax ID family
Rehab Engineering LLC5 organizations share this tax ID, including this one

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1219190400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1401753600000",
    "number": "1356598478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1719 MAHAN DR",
            "city": "TALLAHASSEE",
            "state": "FL",
            "postal_code": "323085201",
            "telephone_number": "850-656-3599",
            "fax_number": "850-656-6483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "311 N DAWSON ST",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317925132",
            "telephone_number": "877-815-6557",
            "fax_number": "850-656-6483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHAB ENGINEERING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-08-20",
        "last_updated": "2014-06-03",
        "status": "A",
        "authorized_official_last_name": "FREDRICK",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "RYAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-656-3599",
        "authorized_official_credential": "CPO"
    },
    "taxonomies": [
        {
            "code": "335E00000X",
            "taxonomy_group": "",
            "desc": "Prosthetic/Orthotic Supplier",
            "state": "GA",
            "license": "14",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "746347392A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Thomasville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.