Active NPI
Rejeana L Dobbs-Grannum, RPT
- Phlebology Physician
- Douglasville, GA
National Provider Identifier
1629699947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Phlebology Physician
- License
- 246078
- Practice address
- 8629 Wood Springs CT
Douglasville, GA 30135-1684 - Phone
- (678) 939-9099
- Fax
- (678) 302-9601
- NPI assigned
- Apr 27, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Phlebology Physician | 202K00000X | 246078 | IL | Primary |
Addresses
Primary practice location
8629 Wood Springs CT
Douglasville, GA 30135-1684
Mailing address
8629 Wood Springs CT
Douglasville, GA 30135-1684
Phone (678) 939-9099
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 246078 | Other | IL | AMT CERTIFICATION |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Other URL | https://www.facebook.com/MobileLabDynamics |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 246078 | IL | MD | Phlebology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1587945600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1587945600000",
"number": "1629699947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8629 WOOD SPRINGS CT",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301351684",
"telephone_number": "678-939-9099",
"fax_number": "678-302-9601"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8629 WOOD SPRINGS CT",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301351684",
"telephone_number": "678-939-9099",
"fax_number": "678-302-9601"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOBBS-GRANNUM",
"first_name": "REJEANA",
"middle_name": "L",
"name_prefix": "Mrs.",
"credential": "RPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-04-27",
"last_updated": "2020-04-27",
"certification_date": "2020-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "202K00000X",
"taxonomy_group": "",
"desc": "Phlebology",
"state": "IL",
"license": "246078",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "AMT CERTIFICATION",
"identifier": "246078",
"state": "IL"
}
],
"endpoints": [
{
"endpointType": "OTHERS",
"endpointTypeDescription": "Other URL",
"endpoint": "https://www.facebook.com/MobileLabDynamics",
"affiliation": "N",
"address_1": "8629 Wood Springs Ct",
"city": "Douglasville",
"state": "GA",
"country_code": "US",
"postal_code": "301351684",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Douglasville, GA
- Diverse Dreams LLC
- Divine Destiny Counseling Services LLC
- Divine Favor Health Care,LLC
- Divine Home Care & Staffing Agency
- Alethea R. Dix, MPT
- Alyssa Dorris, RBT
- Douglas Community Services Board
- Douglas County Board of Commissioner
- Douglas County Board of Health
- Douglas County Community Services Board
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.