Organization Active NPI

Tri-County Rehabilitation & Pain, LLC

  • Physical Medicine & Rehabilitation Physician
  • Fort Oglethorpe, GA
National Provider Identifier
1770530644
Registry record updated Oct 11, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
TRI-COUNTY REHABILITATION & PAIN, LLC
Practice address
102 Gross Crescent Cir
Suite 203
Fort Oglethorpe, GA 30742-3600
Phone
(706) 858-6056
Fax
(706) 858-2412
NPI assigned
May 27, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 11, 2007

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

Authorized official

Name
Dr. Brian Kalla, MD
Title
Auhorized Official
Phone
(706) 858-6056

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 208100000X Primary

Addresses

Primary practice location

102 Gross Crescent Cir
Suite 203
Fort Oglethorpe, GA 30742-3600

Mailing address

102 Gross Crescent Cir
Suite 203
Fort Oglethorpe, GA 30742-3600

National Provider Directory

National Provider Directory

Locations

102 Gross Crescent Cir
Ste 203
Ft Oglethorpe, GA 30742
Phone (706) 858-6056

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148688000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1192060800000",
    "number": "1770530644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 GROSS CRESCENT CIR",
            "address_2": "SUITE 203",
            "city": "FORT OGLETHORPE",
            "state": "GA",
            "postal_code": "307423600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 GROSS CRESCENT CIR",
            "address_2": "SUITE 203",
            "city": "FORT OGLETHORPE",
            "state": "GA",
            "postal_code": "307423600",
            "telephone_number": "706-858-6056",
            "fax_number": "706-858-2412"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-COUNTY REHABILITATION & PAIN, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-27",
        "last_updated": "2007-10-11",
        "status": "A",
        "authorized_official_last_name": "KALLA",
        "authorized_official_first_name": "BRIAN",
        "authorized_official_title_or_position": "AUHORIZED OFFICIAL",
        "authorized_official_telephone_number": "706-858-6056",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Oglethorpe, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2007; 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.