Proactive Rehab, Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

PROACTIVE REHAB, INC

Practice address

50 Lawrenceville Street
Suite 100
McDonough, GA 30252

Phone

(770) 320-7840

NPI assigned

Oct 10, 2011

Organization subpart

No

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

Authorized official

Name

Mr. Joseph Powell, PTNPI 1376612192

Title

Physical Therapist

Phone

(770) 320-7840

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/12689/brand/1/csg/1/fhir/r4

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Joseph Powell

  • Physical Therapist
  • McDonough, GA
  • NPI 1376612192
  Medicare reassignment NPD Authorized official
• Sara Knight, DPT

  • Physical Therapist
  • McDonough, GA
  • NPI 1609154665
  NPD (past)

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

{
    "created_epoch": "1318204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318204800000",
    "number": "1598049447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 LAWRENCEVILLE STREET",
            "address_2": "SUITE 100",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "30252"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 LAWRENCEVILLE STREET",
            "address_2": "SUITE 100",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "30252",
            "telephone_number": "770-320-7840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROACTIVE REHAB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-10-10",
        "last_updated": "2011-10-10",
        "status": "A",
        "authorized_official_last_name": "POWELL",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "770-320-7840",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in McDonough, GA
• Providers in McDonough, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2011; 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.