Organization Active NPI

Fayetteville Rehab Solutions LLC

  • Physical Therapist
  • Fayetteville, GA
National Provider Identifier
1700479607
Registry record updated Apr 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
FAYETTEVILLE REHAB SOLUTIONS LLC
Practice address
535 Glynn St S Ste 20082009
Fayetteville, GA 30214-2029
Phone
(770) 703-3143
Fax
(770) 703-3162
NPI assigned
Feb 11, 2021
Last updated
Apr 24, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2025

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

Authorized official

Name
Jennifer Hayes
Title
Operations Manager
Phone
(334) 531-0793

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

535 Glynn St S Ste 20082009
Fayetteville, GA 30214-2029

Mailing address

535 Glynn St S Ste 20082009
Fayetteville, GA 30214-2029
Phone (770) 703-3143

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210422000274 GA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 0244646859 Receives reassigned benefits from 10 practitioners
Practice locations: Fayetteville, GA; Hampton, GA

National Provider Directory

National Provider Directory

Locations

535 Glynn St S
Ste 2008
Fayetteville, GA 30214
Phone (770) 703-3143

535 Glynn St S
Ste 20082009
Fayetteville, GA 30214
Phone (770) 703-3143

535 Glynn St S
Ste 2009
Fayetteville, GA 30214

990 Bear Creek Blvd
Ste E
Hampton, GA 30228
Phone (770) 707-7905

Practitioners & affiliated clinicians

Practitioners 10

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": "1613001600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745452800000",
    "number": "1700479607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "535 GLYNN ST S STE 20082009",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142029",
            "telephone_number": "770-703-3143",
            "fax_number": "770-703-3162"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 GLYNN ST S STE 20082009",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302142029",
            "telephone_number": "770-703-3143",
            "fax_number": "770-703-3162"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAYETTEVILLE REHAB SOLUTIONS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-11",
        "last_updated": "2025-04-24",
        "certification_date": "2025-04-24",
        "status": "A",
        "authorized_official_last_name": "HAYES",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "OPERATIONS MANAGER",
        "authorized_official_telephone_number": "334-531-0793"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.