NPIMap

Organization Active NPI

Human Performance and Rehabilitation Centers LLC

  • Durable Medical Equipment & Medical Supplies
  • Conyers, GA
National Provider Identifier
1508620808
Registry record updated Feb 8, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
HUMAN PERFORMANCE AND REHABILITATION CENTERS LLC
Practice address
1157B West Ave SW
Conyers, GA 30012-5280
Phone
(770) 922-2420
Fax
(770) 922-1096
NPI assigned
Feb 8, 2024
Last updated
Feb 8, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2024

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

Authorized official

Name
Patrick Donovan Graham, PT, MBA
Title
Co-Ceo/Partner
Phone
(706) 320-5463

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X Primary

Addresses

Primary practice location

1157B West Ave SW
Conyers, GA 30012-5280

Mailing address

1650 Lyndon Farm CT Ste 300
Louisville, KY 40223-5005
Phone (757) 208-4731

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250117001800 GA DME Supplier - Independently-Practicing Physical Therapist 3870908130 Practice locations: Conyers, GA

Other NPIs with the same Medicare PAC ID 4

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

National Provider Directory

National Provider Directory
Tax ID family
Human Performance and Rehab6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

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

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Member organizations 1

Organizations listed as members of this organization in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1707350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707350400000",
    "number": "1508620808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 LYNDON FARM CT STE 300",
            "city": "LOUISVILLE",
            "state": "KY",
            "postal_code": "402235005",
            "telephone_number": "757-208-4731",
            "fax_number": "812-590-8333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1157B WEST AVE SW",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300125280",
            "telephone_number": "770-922-2420",
            "fax_number": "770-922-1096"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUMAN PERFORMANCE AND REHABILITATION CENTERS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-08",
        "last_updated": "2024-02-08",
        "certification_date": "2024-02-08",
        "status": "A",
        "authorized_official_last_name": "GRAHAM",
        "authorized_official_first_name": "PATRICK",
        "authorized_official_middle_name": "DONOVAN",
        "authorized_official_title_or_position": "CO-CEO/PARTNER",
        "authorized_official_telephone_number": "706-320-5463",
        "authorized_official_credential": "PT, MBA"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2024; 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.