Professional Medical & Rehab Clinic

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PROFESSIONAL MEDICAL & REHAB CLINIC

Practice address

2636 Martin Luther King Jr Dr SW
Ste. 12
Atlanta, GA 30311-1634

Phone

(404) 748-4952

Fax

(404) 696-2823

NPI assigned

Nov 15, 2012

Organization subpart

No

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

Authorized official

Name

Mr. Michael Lee

Title

Member

Phone

(404) 748-4952

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Teneka Hosang, PA

  • Physician Assistant
  • Doraville, GA
  • NPI 1356699110
  NPD (past)

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1352937600000",
    "number": "1669716718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2636 MARTIN LUTHER KING JR DR SW",
            "address_2": "STE. 12",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303111634",
            "telephone_number": "404-748-4952",
            "fax_number": "404-696-2823"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2636 MARTIN LUTHER KING JR DR SW",
            "address_2": "STE. 12",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303111634",
            "telephone_number": "404-748-4952",
            "fax_number": "404-696-2823"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL MEDICAL & REHAB CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-11-15",
        "last_updated": "2012-11-15",
        "status": "A",
        "authorized_official_last_name": "LEE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "404-748-4952",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kennedi Proctor, RBT
• Prodigy Therapeutic Solutions LLC
• Professional Care, Inc.
• Professional Counseling Center of Atlanta, LLC
• Professional Dental Alliance of Atlanta Boulevard SE, LLC
• Professional Portable Radiologic Services, Inc.
• Professional Speech & Language Therapy, Inc
• Professional Therapy Providers, Inc
• Progress Counseling and Consulting LLC
• Progress Mental Health LLC

• Primary Care Clinic/Center in Atlanta, GA
• Providers in Atlanta, GA by specialty
• Primary Care Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 15, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.