Regency Hospital Company of South Atlanta, LLC

Primary specialty

Long Term Care HospitalTaxonomy code 282E00000X

License

HOSPL0190 Issued in GA

Legal business name

REGENCY HOSPITAL COMPANY OF SOUTH ATLANTA, LLC

Doing business as

Regency Hospital of South Atlanta

Practice address

1170 Cleveland Ave
Suite 217
East Point, GA 30344-3615

Phone

(404) 466-6250

Fax

(404) 466-6267

NPI assigned

Aug 11, 2005

Organization subpart

No

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

Authorized official

Name

Mr. Michael Tarvin

Title

Vice President

Phone

(717) 972-1100

Specialties & licenses 1

Addresses

Other names 1

• Regency Hospital of South Atlanta Doing business as

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Hospital certification: CCN 110221

Legal name

REGENCY HOSPITAL OF SOUTH ATLANTA

Certification status

Terminated Other: provider status change, Feb 28, 2004

Provider type (POS)

Hospital – Short-term

Participating since

Aug 21, 2003

Last certification

Aug 21, 2003

Beds

40

Ownership / control type

Private (for profit)

Facility address

1170 Cleveland Avenue 4TH Floor
East Point, GA 30344

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Emory University

  dba Emory University Hospital

  • Psychiatric Hospital
  • Atlanta, GA
  • NPI 1437136918

  Member Of

  NPD member

Locations

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

{
    "created_epoch": "1123718400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1284940800000",
    "number": "1750383584",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4714 GETTYSBURG RD",
            "address_2": "LEGAL DPT",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-972-1100",
            "fax_number": "717-975-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1170 CLEVELAND AVE",
            "address_2": "SUITE 217",
            "city": "EAST POINT",
            "state": "GA",
            "postal_code": "303443615",
            "telephone_number": "404-466-6250",
            "fax_number": "404-466-6267"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REGENCY HOSPITAL COMPANY OF SOUTH ATLANTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-08-11",
        "last_updated": "2010-09-20",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-972-1100",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "282E00000X",
            "taxonomy_group": "",
            "desc": "Long Term Care Hospital",
            "state": "GA",
            "license": "HOSPL0190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Regency Hospital of South Atlanta",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Praharsha Ravindranatha Menon, MD
• Shaye Elizabeth Rawson, PA-C
• Lashandra Nichole Rease, NP
• Rebirth Counseling and Training Center
• Mary Latrelle Reese
• Remarkable Home Care Solutions, LLC
• Claude H. Rene-Cunningham, DNP, APN
• Quentin Lashawn Reynolds
• Robin Raquel Reynolds
• Conchata S Richards, MS, LPC, NCC

• Long Term Care Hospital in East Point, GA
• Providers in East Point, GA by specialty
• Long Term Care Hospital in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.