Atlantic Coast Orthopedic Medical Supplies

Primary specialty

Customized Equipment (DME)Taxonomy code 332BC3200X

Legal business name

ATLANTIC COAST ORTHOPEDIC MEDICAL SUPPLIES

Doing business as

Select Rehab

Practice address

9006 Perimeter Woods Dr Ste B
Charlotte, NC 28216-2466

Phone

(704) 921-0116

Fax

(704) 921-0117

NPI assigned

Dec 11, 2018

Organization subpart

No

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

Authorized official

Name

Ms. Lisa Marie Rebaglia

Title

Director of Operations

Phone

(704) 749-6284

Specialties & licenses 1

Addresses

Other names 2

• Select Rehab Doing business as
• ACO Med Supply Other name

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Locations

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

{
    "created_epoch": "1544486400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1686009600000",
    "number": "1821569294",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 744966",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303744966",
            "telephone_number": "704-921-0116",
            "fax_number": "704-921-0117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9006 PERIMETER WOODS DR STE B",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282162466",
            "telephone_number": "704-921-0116",
            "fax_number": "704-921-0117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ATLANTIC COAST ORTHOPEDIC MEDICAL SUPPLIES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-12-11",
        "last_updated": "2023-06-06",
        "certification_date": "2023-06-06",
        "status": "A",
        "authorized_official_last_name": "REBAGLIA",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "MARIE",
        "authorized_official_title_or_position": "DIRECTOR OF OPERATIONS",
        "authorized_official_telephone_number": "704-749-6284",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "332BC3200X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies, Customized Equipment",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Select Rehab",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "ACO Med Supply",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "ACO Med Supply",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Richard O'Neale Atkinson IV, LCSW
• Shanah Antoinette Atkinson, CRNA
• Shikilia Atkinson
• Sonia Z. Atkinson
• Atlantic Coast Home Care
• Atlas Management Care
• Atlas Medical Supply and Equipment
• Atlas Psychological PC
• Atlas Psychological Services, PLLC
• Jennifer Lynn Atlas, MD

• Customized Equipment (DME) in Charlotte, NC
• Providers in Charlotte, NC by specialty
• Customized Equipment (DME) in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.