Developmental & Rehabilitative Service, Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

007234PT Issued in GA

Legal business name

DEVELOPMENTAL & REHABILITATIVE SERVICE, INC

Practice address

5295 Stone Mountain Hwy
Suite I
Stone Mountain, GA 30087-6416

Phone

(770) 879-5646

Fax

(770) 981-2024

NPI assigned

Nov 2, 2006

Organization subpart

No

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

Authorized official

Name

Ms. Denise Edwards, PT

Title

President

Phone

(770) 879-5646

Specialties & licenses 1

Addresses

Other identifiers 3

Locations

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

{
    "created_epoch": "1162425600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397779200000",
    "number": "1700965621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5295 STONE MOUNTAIN HWY",
            "address_2": "SUITE I",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300876416",
            "telephone_number": "770-879-5646",
            "fax_number": "770-981-2024"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5295 STONE MOUNTAIN HWY",
            "address_2": "SUITE I",
            "city": "STONE MOUNTAIN",
            "state": "GA",
            "postal_code": "300876416",
            "telephone_number": "770-879-5646",
            "fax_number": "770-981-2024"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DEVELOPMENTAL & REHABILITATIVE SERVICE, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-02",
        "last_updated": "2014-04-18",
        "status": "A",
        "authorized_official_last_name": "EDWARDS",
        "authorized_official_first_name": "DENISE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-879-5646",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "GA",
            "license": "007234PT",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "309589",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000950595D",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "10039295",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Physical Therapist in Stone Mountain, GA
• Providers in Stone Mountain, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2014; 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.