Sports Medicine and Rehab Therapy Camden

Primary specialty

Physical TherapistTaxonomy code 225100000X

Legal business name

SPORTS MEDICINE AND REHAB THERAPY CAMDEN

Practice address

1891 Hwy 40 E Ste 1104
Kingsland, GA 31548-6573

Phone

(912) 522-8404

Fax

(912) 522-8406

NPI assigned

Feb 16, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Clayton Conners, PT, DPT, OCSNPI 1275900508

Title

Physical Therapist

Phone

(912) 522-8404

Specialties & licenses 1

Addresses

Other names 1

• SMART Physical Therapy Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Practitioners 4

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

• Clayton Conners, DPT

  • Physical Therapist
  • Jesup, GA
  • NPI 1275900508
  Medicare reassignment Care Compare group NPD Authorized official
• Sarah M Duman, PT, MSPT, CERT. MDT

  • Physical Therapist
  • Kingsland, GA
  • NPI 1912709247
  Medicare reassignment Care Compare group NPD
• Lisa Leanne Gentzler, M.P.T.

  • Physical Therapist
  • Kingsland, GA
  • NPI 1093898991
  Medicare reassignment NPD
• Walter Lee Bishop, PT

  • Physical Therapist
  • Waycross, GA
  • NPI 1609813229
  NPD

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

{
    "created_epoch": "1676505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696982400000",
    "number": "1821796145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1891 HWY 40 E STE 1104",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486573",
            "telephone_number": "912-522-8404",
            "fax_number": "912-522-8406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1891 HWY 40 E STE 1104",
            "city": "KINGSLAND",
            "state": "GA",
            "postal_code": "315486573",
            "telephone_number": "912-522-8404",
            "fax_number": "912-522-8406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPORTS MEDICINE AND REHAB THERAPY CAMDEN",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-16",
        "last_updated": "2023-10-11",
        "certification_date": "2023-10-11",
        "status": "A",
        "authorized_official_last_name": "CONNERS",
        "authorized_official_first_name": "CLAYTON",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "912-522-8404",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT, OCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SMART Physical Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sorinity Support Services, LLC
• Shauna Soule, LCSW
• Southeast Georgia Counseling & Play Therapy, LLC
• Southeast Treatment Center LLC
• Spine Center of Southeast Georgia LLC
• Audrey Lou St. John, MMP, CNMT, LMT
• Stephanie Marie Stetter, COTA
• Patricia A Sullivan, CCC-SLP
• Allyson M Sunderman, DPT
• Shelby B Sweat, PT

• Physical Therapist in Kingsland, GA
• Providers in Kingsland, GA by specialty
• Physical Therapist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.