NPIMap

Cobb Hospital, Inc

Organization Active NPI Rehabilitation Hospital Unit · Austell, GA

NPI 1619967494 · NPPES record last updated Oct 31, 2024

Key facts

NPI
1619967494
Entity type
Organization (NPI type 2)
Primary specialty
Rehabilitation Hospital Unit 273Y00000X
License
033-432 (GA)
Legal business name
COBB HOSPITAL, INC
Practice address
3950 Austell Rd
Inpatient Rehab Unit/3 North
Austell, GA 30106-1121
Phone
(470) 644-0012
NPI assigned
Oct 24, 2005
Organization subpart
No

Authorized official

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

Owners & managing parties with NPI records 3

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

Owned or controlled facilities with NPI records 1

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

Other NPIs with the same Medicare PAC ID 1

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

Corporate family (same 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.

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

Facilities with the same owner 18

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

Affiliated clinicians 19

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

Medicare Care Compare: Inpatient rehabilitation facility

Listed as
Wellstar Cobb Hospital CCN 11T143
Ownership
Government
Certified
Jul 1, 1997

Source: Medicare Care Compare.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Hospital certification: CCN 11T143

Legal name
COBB HOSPITAL INC
Doing business as
WELLSTAR COBB HOSPITAL INPATIENT REHAB UNIT
Organization structure
Corporation · Non-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

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 Director
Board Member		 Jul 1, 2015 5%
Heather Graham
Individual 		Corporate Director
Board Member		 Sep 1, 2025 5%
Joseph a Reppert
Individual 		Corporate Officer
Senior Vice President of Finance		 Apr 4, 2024 100%
W-2 Managing Employee
Senior Vice President of Finance		 Aug 3, 2020 100%
Orrin S Swayze
Individual 		Corporate Director
Board Member		 Jul 1, 2014 5%
John C McKibben
Individual 		Corporate Director
Board Member		 Aug 1, 2019 5%
Keith Parker
Individual 		Corporate Director
Board Member		 Jul 1, 2023 5%
Paul Lawrence Douglass
Individual 		Corporate Director
Board Member		 Aug 22, 2016 5%
Mitzi Moore
Individual 		Corporate Director
Board 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 Director
Board Member		 Oct 3, 2024 5%
John Kerndl
Individual 		Corporate Officer
Evp & Cfo		 Feb 17, 2025 100%
W-2 Managing Employee
Evp & Cfo		 Feb 17, 2025 100%
James Glen Cunningham
Individual 		Corporate Director
Board Member		 Mar 4, 2021 5%
Ebenezer Erzuah
Individual 		W-2 Managing Employee
Exec Dir of Reimbursement		 Jul 1, 2015 100%
Mark Berry
Individual 		Corporate Director
Board Member		 Oct 7, 2021 5%
James Holmes
Individual 		Corporate Director
Board Member		 Apr 4, 2019 5%
Greg Morgan
Individual 		Corporate Director
Board Member		 Jul 1, 2014 5%
James L Hornsby
Individual 		Corporate Director
Board Member		 Jul 1, 2018 5%
Edward Richardson
Individual 		Corporate Director
Board Member		 Apr 4, 2019 5%
David Bottoms
Individual 		Corporate Director
Board Member		 Feb 2, 2023 5%
Frank Ros
Individual 		Corporate Director
Board Member		 Jun 30, 2012 5%

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 Hospice
Austell, GA · CCN 111507		 Hospice 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jul 1, 2009
Jul 1, 2009

Medicare enrollment records

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

National Provider Directory

Tax ID family
Cobb Hosp Medical Cen (4 organizations share this tax ID)

Locations

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

Specialties & licenses

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

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

  • WellStar Cobb Hospital Inpatient Rehab Unit Doing business as

Electronic endpoints

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

Other providers in Austell, GA

All providers in Austell, GA · Rehabilitation Hospital Unit in Georgia

Sources for this page

Verify at the official NPI Registry.