NPIMap

Organization Active NPI

Cobb Hospital, Inc

Doing business as WellStar Cobb Hospital Inpatient Rehab Unit

  • Rehabilitation Hospital Unit
  • Austell, GA
National Provider Identifier
1619967494
Registry record updated Oct 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
License
033-432 Issued in GA
Legal business name
COBB HOSPITAL, INC
Doing business as
WellStar Cobb Hospital Inpatient Rehab Unit
Practice address
3950 Austell Rd
Inpatient Rehab Unit/3 North
Austell, GA 30106-1121
Phone
(470) 644-0012
NPI assigned
Oct 24, 2005
Last updated
Oct 31, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 31, 2024

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

Authorized official

Name
Mr. Anthony J Budzinski
Title
Evp
Phone
(470) 644-0012

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X 033-432 GA Primary

Addresses

Primary practice location

3950 Austell Rd
Inpatient Rehab Unit/3 North
Austell, GA 30106-1121

Mailing address

1800 Parkway PL SE Ste 500
Marietta, GA 30067-8237
Phone (470) 956-4981

Other names 1

  • WellStar Cobb Hospital Inpatient Rehab Unit Doing business as

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service Other Cobius Healthcare Solutions

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080306000434 GA Part A Provider - Hospital 6507764230 Practice locations: Austell, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1619967494. Details of each certification follow.

Hospital certification: CCN 11T143

Legal name
COBB HOSPITAL INC
Doing business as
WELLSTAR COBB HOSPITAL INPATIENT REHAB UNIT
Organization structure
CorporationNon-profit
Incorporated
Aug 22, 1984 in GA
Enrollment address
3950 Austell Rd
3 North
Austell, GA 30106-1121
Hospital Rehabilitation Unit
Hospital subgroups
Rehabilitation unit

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 1

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

Care Compare: Inpatient rehabilitation facility

Medicare Care Compare
Listed as
Wellstar Cobb HospitalCCN 11T143 · All quality measures
Ownership
Government
Certified
Jul 1, 1997

National Provider Directory

National Provider Directory
Tax ID family
Cobb Hosp Medical Cen4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

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

Member organizations 1

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

Locations

3950 Austell Rd
Unit 3
Austell, GA 30106
Phone (470) 644-0012

Ownership & related parties

All disclosed owners & managing parties 20

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
William C Brock Individual Corporate DirectorBoard Member Jul 1, 2015 5%
Heather Graham Individual Corporate DirectorBoard Member Sep 1, 2025 5%
Joseph a Reppert Individual Corporate OfficerSenior Vice President of Finance Apr 4, 2024 100%
W-2 Managing EmployeeSenior Vice President of Finance Aug 3, 2020 100%
Orrin S Swayze Individual Corporate DirectorBoard Member Jul 1, 2014 5%
John C McKibben Individual Corporate DirectorBoard Member Aug 1, 2019 5%
Keith Parker Individual Corporate DirectorBoard Member Jul 1, 2023 5%
Paul Lawrence Douglass Individual Corporate DirectorBoard Member Aug 22, 2016 5%
Mitzi Moore Individual Corporate DirectorBoard Member Jul 1, 2014 5%
Wellstar Health System Inc Organization, Marietta, GA Non-profit 5% Or Greater Direct Ownership Interest Nov 6, 2007 100%
Gretchen Corbin Individual Corporate DirectorBoard Member Oct 3, 2024 5%
John Kerndl Individual Corporate OfficerEvp & Cfo Feb 17, 2025 100%
W-2 Managing EmployeeEvp & Cfo Feb 17, 2025 100%
James Glen Cunningham Individual Corporate DirectorBoard Member Mar 4, 2021 5%
Ebenezer Erzuah Individual W-2 Managing EmployeeExec Dir of Reimbursement Jul 1, 2015 100%
Mark Berry Individual Corporate DirectorBoard Member Oct 7, 2021 5%
James Holmes Individual Corporate DirectorBoard Member Apr 4, 2019 5%
Greg Morgan Individual Corporate DirectorBoard Member Jul 1, 2014 5%
James L Hornsby Individual Corporate DirectorBoard Member Jul 1, 2018 5%
Edward Richardson Individual Corporate DirectorBoard Member Apr 4, 2019 5%
David Bottoms Individual Corporate DirectorBoard Member Feb 2, 2023 5%
Frank Ros Individual Corporate DirectorBoard Member Jun 30, 2012 5%

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Wellstar Community HospiceAustell, GA, CCN 111507 Hospice 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jul 1, 2009
Jul 1, 2009

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 18

Facilities that share an organizational owner with 5% or greater ownership or operational control.

View all 18

Practitioners & affiliated clinicians

Affiliated clinicians 19

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1130112000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1730332800000",
    "number": "1619967494",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1800 PARKWAY PL SE STE 500",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300678237",
            "telephone_number": "470-956-4981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3950 AUSTELL RD",
            "address_2": "INPATIENT REHAB UNIT/3 NORTH",
            "city": "AUSTELL",
            "state": "GA",
            "postal_code": "301061121",
            "telephone_number": "470-644-0012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBB HOSPITAL, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-10-24",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-21",
        "status": "A",
        "authorized_official_last_name": "BUDZINSKI",
        "authorized_official_first_name": "ANTHONY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "EVP",
        "authorized_official_telephone_number": "470-644-0012",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "GA",
            "license": "033-432",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://cobiusconnect.cobius.com:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRRequest_Service",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.1068.1",
            "affiliationName": "Cobius Healthcare Solutions",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "2720 Dundee Rd # 302",
            "city": "Northbrook",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600622609",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "organization_name": "WellStar Cobb Hospital Inpatient Rehab Unit",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "WellStar Cobb Hospital Inpatient Rehab Unit",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Austell, GA

Sources for this page

Verify at the official NPI Registry.