NPIMap

Organization Active NPI

Effingham Rehab Services, LLC

Doing business as CORA Physical Therapy - Kingsland

  • Rehabilitation Clinic/Center
  • Kingsland, GA
National Provider Identifier
1780264994
Registry record updated Oct 4, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
EFFINGHAM REHAB SERVICES, LLC
Doing business as
CORA Physical Therapy - Kingsland
Practice address
1390 Boone Avenue Ext Ste A23
Kingsland, GA 31548-6515
Phone
(419) 221-6717
Fax
(419) 222-0507
NPI assigned
Apr 12, 2021
Last updated
Oct 4, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 4, 2023

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

Authorized official

Name
Stephen Krzyminski
Title
Exec VP
Phone
(419) 221-6717

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

1390 Boone Avenue Ext Ste A23
Kingsland, GA 31548-6515

Mailing address

PO Box 150
Lima, OH 45802-0150
Phone (419) 221-6717

Other names 1

  • CORA Physical Therapy - Kingsland Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20180723000980 GA Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5597752063 Receives reassigned benefits from 13 practitioners
4 other NPIs on this enrollment
Practice locations: Brunswick, GA; Jesup, GA; Kingsland, GA; Pooler, GA; Savannah, GA
O20210830003529 GA Part A Provider - Outpatient Physical Therapy/Occupational Therapy/Speech Pathology Services 5597752063 1 other NPI on this enrollment
Practice locations: Brunswick, GA; Kingsland, GA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1780264994. Details of each certification follow.

  • CCN 116914 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 116914

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
CORA PHYSICAL THERAPY - KINGSLAND
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
May 4, 2022
Last certification
May 4, 2022
Ownership / control type
Proprietary
Facility address
1390 Boone Avenue, Suite A23
Kingsland, GA 31548

Other NPIs with the same Medicare PAC ID 2

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

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory
Tax ID family
Effingham Rehab Servcies7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

Member of 1

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

Practitioners & affiliated clinicians

Practitioners 45

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 45

NPI Registry JSON

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

{
    "created_epoch": "1618185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696377600000",
    "number": "1780264994",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 150",
            "city": "LIMA",
            "state": "OH",
            "postal_code": "458020150",
            "telephone_number": "419-221-6717",
            "fax_number": "419-222-0507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1390 BOONE AVENUE EXT STE A23",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486515",
            "telephone_number": "419-221-6717",
            "fax_number": "419-222-0507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EFFINGHAM REHAB SERVICES, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-12",
        "last_updated": "2023-10-04",
        "certification_date": "2023-10-04",
        "status": "A",
        "authorized_official_last_name": "KRZYMINSKI",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_title_or_position": "EXEC VP",
        "authorized_official_telephone_number": "419-221-6717"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CORA Physical Therapy - Kingsland",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CORA Physical Therapy - Kingsland",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Kingsland, GA

Sources for this page

Verify at the official NPI Registry.