NPIMap

Organization Active NPI

Middle Georgia Family Rehab

  • Health Maintenance Organization
  • Byron, GA
National Provider Identifier
1366844367
Registry record updated Sep 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
License
PT002436 Issued in GA
Legal business name
MIDDLE GEORGIA FAMILY REHAB
Practice address
100 Hamilton Pointe Dr.
Suite 115 & 120
Byron, GA 31008
Phone
(478) 956-4916
Fax
(478) 956-0958
NPI assigned
Sep 22, 2014
Last updated
Sep 22, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 22, 2014

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

Authorized official

Name
Brenda Hicks
Title
Office Manager
Phone
(478) 956-4916

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X PT002436 GA Primary

Addresses

Primary practice location

100 Hamilton Pointe Dr.
Suite 115 & 120
Byron, GA 31008

Mailing address

100 Hamilton Pointe Dr
P.O. Box 1552
Byron, GA 31008
Phone (478) 956-4916

National Provider Directory

National Provider Directory
Tax ID family
Middle Georgia Family Rehab2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

Locations

4671 Mercer University Dr
Macon, GA 31210
Phone (478) 475-9990

5021 Mercer University Dr
Macon, GA 31210
Phone (478) 845-3520

5021 Mercer University Dr
Ste D2
Macon, GA 31210
Phone (478) 845-3520

Practitioners & affiliated clinicians

Practitioners 23

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.

View all 23

NPI Registry JSON

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

{
    "created_epoch": "1411344000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1411344000000",
    "number": "1366844367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 HAMILTON POINTE DR",
            "address_2": "P.O. BOX 1552",
            "city": "BYRON",
            "state": "GA",
            "postal_code": "31008",
            "telephone_number": "478-956-4916"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 HAMILTON POINTE DR.",
            "address_2": "SUITE 115 & 120",
            "city": "BYRON",
            "state": "GA",
            "postal_code": "31008",
            "telephone_number": "478-956-4916",
            "fax_number": "478-956-0958"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDDLE GEORGIA FAMILY REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-09-22",
        "last_updated": "2014-09-22",
        "status": "A",
        "authorized_official_last_name": "HICKS",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "478-956-4916"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "GA",
            "license": "PT002436",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Byron, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2014; 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.