NPIMap

Organization Active NPI

Southeast Rehabilitation Group Inc

  • Physical Therapy Clinic/Center
  • Roswell, GA
National Provider Identifier
1437855830
Registry record updated Jul 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
Legal business name
SOUTHEAST REHABILITATION GROUP INC
Practice address
875 Mansell Rd Ste H
Roswell, GA 30076-4800
Phone
(678) 821-2170
Fax
(678) 821-2169
NPI assigned
Feb 7, 2023
Last updated
Jul 30, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2023

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

Authorized official

Name
Ion Toma
Title
President
Phone
(404) 578-0233

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X Primary

Addresses

Primary practice location

875 Mansell Rd Ste H
Roswell, GA 30076-4800

Mailing address

4342 Collingham Trce NE
Marietta, GA 30068-2705
Phone (404) 578-0233

Other practice location 1

4941 S Old Peachtree Rd Ste D
Peachtree Corners, GA 30092-3495
Phone (678) 335-2080

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230404002315 GA Part B Supplier - Clinic/Group Practice 7618341454 Receives reassigned benefits from 7 practitioners
Practice locations: Peachtree Corners, GA; Roswell, GA

National Provider Directory

National Provider Directory

Locations

4941 S Old Peachtree Rd
Ste D
Peachtree Corners, GA 30092
Phone (678) 335-2080

4941 S Old Peachtree Rd
Peachtree Corners, GA 30092

875 Mansell Rd
Ste H
Roswell, GA 30076
Phone (678) 821-2170

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1675728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690675200000",
    "number": "1437855830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4342 COLLINGHAM TRCE NE",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300682705",
            "telephone_number": "404-578-0233"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 MANSELL RD STE H",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300764800",
            "telephone_number": "678-821-2170",
            "fax_number": "678-821-2169"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4941 S Old Peachtree Rd Ste D",
            "address_purpose": "LOCATION",
            "city": "Peachtree Corners",
            "state": "GA",
            "postal_code": "300923495",
            "country_code": "US",
            "telephone_number": "678-335-2080",
            "fax_number": "678-335-2079",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTHEAST REHABILITATION GROUP INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-07",
        "last_updated": "2023-07-30",
        "certification_date": "2023-07-30",
        "status": "A",
        "authorized_official_last_name": "TOMA",
        "authorized_official_first_name": "ION",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "404-578-0233"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Roswell, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2023; 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.