Restoration Healthcare of Commerce, LLC

Primary specialty

General Acute Care HospitalTaxonomy code 282N00000X

License

78-12 Issued in GA

Legal business name

RESTORATION HEALTHCARE OF COMMERCE, LLC

Practice address

70 Medical Center Dr
Commerce, GA 30529-1078

Phone

(706) 335-1000

Fax

(706) 335-7701

NPI assigned

May 6, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Stephen N Clapp

Title

President

Phone

(865) 607-9923

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• BJC Medical Center Doing business as

Tax ID family

BJC Medical Center3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

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

• Restoration Healthcare of Commerce LLC

  • Durable Medical Equipment & Medical Supplies
  • Commerce, GA
  • NPI 1740577949
  NPD tax ID
• Restoration Healthcare of Commerce, LLC

  • Nursing Facility/Intermediate Care Facility
  • Commerce, GA
  • NPI 1376860403
  NPD tax ID

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

{
    "created_epoch": "1273104000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1273104000000",
    "number": "1427376136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 MEDICAL CENTER DR",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305291078",
            "telephone_number": "706-335-1000",
            "fax_number": "706-335-7701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 MEDICAL CENTER DR",
            "city": "COMMERCE",
            "state": "GA",
            "postal_code": "305291078",
            "telephone_number": "706-335-1000",
            "fax_number": "706-335-7701"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESTORATION HEALTHCARE OF COMMERCE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-05-06",
        "last_updated": "2010-05-06",
        "status": "A",
        "authorized_official_last_name": "CLAPP",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "N",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "865-607-9923",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "275N00000X",
            "taxonomy_group": "",
            "desc": "Medicare Defined Swing Bed Unit",
            "state": "GA",
            "license": "78-12",
            "primary": false
        },
        {
            "code": "282N00000X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital",
            "state": "GA",
            "license": "78-12",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "SWING BED PROVIDER NUMBER",
            "identifier": "11U040",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000151A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BJC Medical Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Restoration Health Care of Commerce, LLC
• Restoration Healthcare
• Restoration Healthcare of Commerce LLC
• Restoration Healthcare of Commerce LLC
• Restoration Healthcare of Commerce, LLC
• Ridgeway Family Practice, PC
• Brenda E Rosado Gonzalez, O.D., MBA
• Jennifer Kay Rubner, CPNP-PC
• Raedeen S Russell, PHD
• David M Russo

• General Acute Care Hospital in Commerce, GA
• Providers in Commerce, GA by specialty
• General Acute Care Hospital in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2010; 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.