Organization Active NPI

Activekidz and Adult Therapy Services

  • Pediatric Rehabilitation Medicine Physician
  • Rome, GA
National Provider Identifier
1720834302
Registry record updated Apr 25, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Rehabilitation Medicine PhysicianTaxonomy code 2081P0010X
Legal business name
ACTIVEKIDZ AND ADULT THERAPY SERVICES
Practice address
212 W 3Rd St SW
Rome, GA 30165-2802
Phone
(706) 295-4260
NPI assigned
Apr 25, 2024
Last updated
Apr 25, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 25, 2024

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

Authorized official

Name
Susan Gerald CookNPI 1295775955
Title
Owner
Phone
(770) 207-6390

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Rehabilitation Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2081P0010X Primary

Addresses

Primary practice location

212 W 3Rd St SW
Rome, GA 30165-2802

Mailing address

1431 Capital Ave Ste 123
Watkinsville, GA 30677-1883

National Provider Directory

National Provider Directory
Tax ID family
Activekidz and Adult Therapy Services3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

Locations

212 W 3rd St SW
Rome, GA 30165
Phone (706) 295-4242

Practitioners & affiliated clinicians

Practitioners 1

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": "1714003200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1714003200000",
    "number": "1720834302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1431 CAPITAL AVE STE 123",
            "city": "WATKINSVILLE",
            "state": "GA",
            "postal_code": "306771883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "212 W 3RD ST SW",
            "city": "ROME",
            "state": "GA",
            "postal_code": "301652802",
            "telephone_number": "706-295-4260"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ACTIVEKIDZ AND ADULT THERAPY SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-04-25",
        "last_updated": "2024-04-25",
        "certification_date": "2024-04-25",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "GERALD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "770-207-6390"
    },
    "taxonomies": [
        {
            "code": "2081P0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pediatric Rehabilitation Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rome, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2024; 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.