NPIMap

Organization Active NPI

Developmental & Rehabilitative Services 2, Inc

  • Physical Therapist
  • Conyers, GA
National Provider Identifier
1578055307
Registry record updated Jun 16, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT007234 Issued in GA
Legal business name
DEVELOPMENTAL & REHABILITATIVE SERVICES 2, INC
Practice address
2395 Wall St SE Ste 176
Conyers, GA 30013-6703
Phone
(770) 679-1553
Fax
(866) 666-4344
NPI assigned
Jun 6, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2018

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

Authorized official

Name
Dr. Denise Edwards, DPTNPI 1750350328
Title
President/Ceo
Phone
(770) 679-1553

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
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X PT007234 GA Primary

Addresses

Primary practice location

2395 Wall St SE Ste 176
Conyers, GA 30013-6703

Mailing address

2395 Wall St SE Ste 176
Conyers, GA 30013-6703
Phone (770) 679-1553

Other identifiers 1

IdentifierTypeStateIssuer
000950595HMedicaidGA

National Provider Directory

National Provider Directory

Locations

2395 Wall St SE
Ste 176
Conyers, GA 30013
Phone (770) 679-1553

Practitioners & affiliated clinicians

Practitioners 8

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": "1528243200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1529107200000",
    "number": "1578055307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2395 WALL ST SE STE 176",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136703",
            "telephone_number": "770-679-1553",
            "fax_number": "866-666-4344"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2395 WALL ST SE STE 176",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300136703",
            "telephone_number": "770-679-1553",
            "fax_number": "866-666-4344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENTAL & REHABILITATIVE SERVICES 2, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-06-06",
        "last_updated": "2018-06-16",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "PRESIDENT/CEO",
        "authorized_official_telephone_number": "770-679-1553",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "PT007234",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000950595H",
            "state": "GA"
        }
    ],
    "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 Jun 16, 2018; 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.