Individual provider Active NPI

Eric David Solomon, D.O.

  • Physical Medicine & Rehabilitation Physician
  • Marietta, GA
National Provider Identifier
1740267640
Registry record updated Aug 20, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
046649 Issued in GA
Practice address
1395 S Marietta Pkwy SE
BLDG 100 Ste 102
Marietta, GA 30067-4440
Phone
(770) 425-8700
Fax
(770) 425-8740
NPI assigned
Dec 30, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 20, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation Physician 208100000X 046649 GA Primary

Addresses

Primary practice location

1395 S Marietta Pkwy SE
BLDG 100 Ste 102
Marietta, GA 30067-4440

Mailing address

1395 S Marietta Pkwy SE
BLDG 100 Ste 102
Marietta, GA 30067-4440
Phone (770) 425-8700

Other identifiers 1

IdentifierTypeStateIssuer
00809751AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051129000954 GA Practitioner - Physical Medicine and Rehabilitation 0345260865 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Medicine and Rehabilitation
Education
Kansas City University of Med & Biosciences, College of Osteo Med, 1986
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Chronic Pain Clinics of America LLCGroup PAC ID 2466406087, 2 clinicians

Practice addresses (Care Compare)

1395 S Marietta Pkwy SE
BLDG 100 Suite 102
Marietta, GA 30067-7852

1395 S Marietta Sepkwy
Suite 102
Marietta, GA 30067-7852
Phone (770) 425-8700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
046649GAMDPhysical Medicine & Rehabilitation Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Chronic Pain Clinics of America LLC CurrentSince Aug 1, 2014 Accepting new patients

Locations

1395 S Marietta Pkwy SE
Ste 102
Marietta, GA 30067
Phone (770) 425-8700

1395 S Marietta Pkwy SE
Ste 101
Marietta, GA 30067
Phone (770) 420-8017

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1135900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440028800000",
    "number": "1740267640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1395 S MARIETTA PKWY SE",
            "address_2": "BLDG 100 STE 102",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300674440",
            "telephone_number": "770-425-8700",
            "fax_number": "770-425-8740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1395 S MARIETTA PKWY SE",
            "address_2": "BLDG 100 STE 102",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300674440",
            "telephone_number": "770-425-8700",
            "fax_number": "770-425-8740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLOMON",
        "first_name": "ERIC",
        "middle_name": "DAVID",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-12-30",
        "last_updated": "2015-08-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "GA",
            "license": "046649",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00809751A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Marietta, GA

Sources for this page

Verify at the official NPI Registry.