NPIMap

Organization Active NPI

Georgia Rehabilitation Outreach

  • Clinical Social Worker
  • East Point, GA
National Provider Identifier
1699868117
Registry record updated Oct 11, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
1041C0700X Issued in GA
Legal business name
GEORGIA REHABILITATION OUTREACH
Practice address
1777 Washington Road
East Point, GA 30344
Phone
(404) 892-0998
Fax
(404) 872-0095
NPI assigned
Oct 2, 2006
Last updated
Oct 11, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2011

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

Authorized official

Name
Brenda Bell
Title
Chief Operating Officer
Phone
(404) 892-0998

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 1041C0700X GA Primary

Addresses

Primary practice location

1777 Washington Road
East Point, GA 30344

Mailing address

1777 Washington Road
East Point, GA 30344
Phone (404) 892-0998

Other identifiers 1

IdentifierTypeStateIssuer
00914394AMedicaidGA

National Provider Directory

National Provider Directory

Locations

60 11th St NE
Atlanta, GA 30309
Phone (404) 589-9040

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1159747200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1318291200000",
    "number": "1699868117",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1777 WASHINGTON ROAD",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "30344",
            "telephone_number": "404-892-0998",
            "fax_number": "404-872-0095"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1777 WASHINGTON ROAD",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "30344",
            "telephone_number": "404-892-0998",
            "fax_number": "404-872-0095"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA REHABILITATION OUTREACH",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-02",
        "last_updated": "2011-10-11",
        "status": "A",
        "authorized_official_last_name": "BELL",
        "authorized_official_first_name": "BRENDA",
        "authorized_official_title_or_position": "CHIEF OPERATING OFFICER",
        "authorized_official_telephone_number": "404-892-0998"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "GA",
            "license": "1041C0700X",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00914394A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Point, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2011; 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.