Organization Active NPI

Rehabilitation Concepts, LLC

  • Clinic/Center
  • Ellenwood, GA
National Provider Identifier
1386030658
Registry record updated Apr 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
License
PT007592 Issued in GA
Legal business name
REHABILITATION CONCEPTS, LLC
Practice address
5455 Frontier CT
Ellenwood, GA 30294-4385
Phone
(850) 261-5286
NPI assigned
Apr 13, 2015
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 13, 2015

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

Authorized official

Name
Dr. Michael Henry Jr., PT, DPTNPI 1427451244
Title
Owner
Phone
(850) 261-5286

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
Clinic/Center 261Q00000X PT007592 GA Primary

Addresses

Primary practice location

5455 Frontier CT
Ellenwood, GA 30294-4385

Mailing address

1938 Peachtree Rd NW
Suite 610
Atlanta, GA 30309-1267

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20150727001099 GA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 2365756954 Receives reassigned benefits from 1 practitioner
Practice locations: Decatur, GA

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1428883200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1428883200000",
    "number": "1386030658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1938 PEACHTREE RD NW",
            "address_2": "SUITE 610",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303091267"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5455 FRONTIER CT",
            "city": "ELLENWOOD",
            "state": "GA",
            "postal_code": "302944385",
            "telephone_number": "850-261-5286"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REHABILITATION CONCEPTS, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-04-13",
        "last_updated": "2015-04-13",
        "status": "A",
        "authorized_official_last_name": "HENRY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "850-261-5286",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "PT, DPT"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "GA",
            "license": "PT007592",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ellenwood, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2015; 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.