Active NPI
Roman Rehab Inc.
- Customized Equipment (DME)
- Rome, GA
National Provider Identifier
1639171689
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Customized Equipment (DME)
- License
- 001084
- Legal business name
- ROMAN REHAB INC.
- Doing business as
- Roman Wheelchairs
- Practice address
- 432 Shorter Ave NW
Rome, GA 30165-4272 - Phone
- (706) 235-8113
- Fax
- (706) 235-9108
- NPI assigned
- Jun 2, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Bruce Edward Van Hoorn, CRTS
- Title
- President
- Phone
- (706) 235-8113
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Customized Equipment (DME) | 332BC3200X | 001084 | GA | Primary |
Addresses
Primary practice location
432 Shorter Ave NW
Rome, GA 30165-4272
Mailing address
432 Shorter Ave NW
Rome, GA 30165-4272
Phone (706) 235-8113
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00891987A | Medicaid | GA |
Other names 1
- Roman Wheelchairs
National Provider Directory
National Provider DirectoryLocations
432 Shorter Ave NW
Rome, GA 30165
Phone (706) 235-8113
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1117670400000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1639171689",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "432 SHORTER AVE NW",
"city": "ROME",
"state": "GA",
"postal_code": "301654272",
"telephone_number": "706-235-8113",
"fax_number": "706-235-9108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "432 SHORTER AVE NW",
"city": "ROME",
"state": "GA",
"postal_code": "301654272",
"telephone_number": "706-235-8113",
"fax_number": "706-235-9108"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "ROMAN REHAB INC.",
"organizational_subpart": "NO",
"enumeration_date": "2005-06-02",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "VAN HOORN",
"authorized_official_first_name": "BRUCE",
"authorized_official_middle_name": "EDWARD",
"authorized_official_title_or_position": "PRESIDENT",
"authorized_official_telephone_number": "706-235-8113",
"authorized_official_name_prefix": "Mr.",
"authorized_official_credential": "CRTS"
},
"taxonomies": [
{
"code": "332BC3200X",
"taxonomy_group": "",
"desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
"state": "GA",
"license": "001084",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00891987A",
"state": "GA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Roman Wheelchairs",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Rome, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.