NPIMap

Organization Active NPI

Northeast Georgia Medical Center, Inc.

  • Rehabilitation Hospital Unit
  • Gainesville, GA
National Provider Identifier
1720015993
Registry record updated Apr 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
NORTHEAST GEORGIA MEDICAL CENTER, INC.
Practice address
743 Spring St NE
Gainesville, GA 30501-3715
Phone
(770) 219-9000
Fax
(770) 219-6694
NPI assigned
Jun 26, 2006
Last updated
Apr 22, 2020By the provider in NPPES
Organization subpart
Yes
Parent organization
NORTHEAST GEORGIA MEDICAL CENTER INC.As reported in NPPES

NPPES NPI Registry

Updated by the provider on Apr 22, 2020

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

Authorized official

Name
Brian D Steines
Title
Cfo
Phone
(770) 219-3562

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X GA Primary

Addresses

Primary practice location

743 Spring St NE
Gainesville, GA 30501-3715

Mailing address

PO Box 741891
Atlanta, GA 30374-1891
Phone (770) 219-9000

Other identifiers 1

IdentifierTypeStateIssuer
000000888AMedicaidGA

Other names 1

  • REHAB UNIT Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040422000903 GA Part B Supplier - Clinic/Group Practice 7517953755 Receives reassigned benefits from 61 practitioners
2 other NPIs on this enrollment
Practice locations: Gainesville, GA

Other NPIs with the same Medicare PAC ID 4

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Northeast Georgia Medical Center Inc

Ownership & related parties

All facility ownership & control disclosures 2

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Northeast Georgia Rehabilitation InstituteGainesville, GA, CCN 113039 Hospital 5% Or Greater Direct Ownership Interest (51%) Jun 3, 2025
New Horizons Lanier ParkGainesville, GA, CCN 115487 Skilled nursing facility Operational/Managerial Control (100%) Feb 4, 2008

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 61

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.

View all 61

NPI Registry JSON

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

{
    "created_epoch": "1151280000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1587513600000",
    "number": "1720015993",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 741891",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303741891",
            "telephone_number": "770-219-9000",
            "fax_number": "770-219-6694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "743 SPRING ST NE",
            "city": "GAINESVILLE",
            "state": "GA",
            "postal_code": "305013715",
            "telephone_number": "770-219-9000",
            "fax_number": "770-219-6694"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHEAST GEORGIA MEDICAL CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "NORTHEAST GEORGIA MEDICAL CENTER INC.",
        "enumeration_date": "2006-06-26",
        "last_updated": "2020-04-22",
        "certification_date": "2020-04-22",
        "status": "A",
        "authorized_official_last_name": "STEINES",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "770-219-3562"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "GA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000000888A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "REHAB UNIT",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "REHAB UNIT",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Gainesville, GA

Sources for this page

Verify at the official NPI Registry.