Cobblestone Rehabilitation and Healthcare Center, LLC

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

COBBLESTONE REHABILITATION AND HEALTHCARE CENTER, LLC

Practice address

101 Cobblestone Trce SE
Moultrie, GA 31788-7747

Phone

(229) 985-3637

Fax

(229) 985-3271

NPI assigned

Jul 3, 2010

Last updated

Nov 8, 2017By the provider in NPPES

Organization subpart

Yes

Parent organization

OLIVE LEAF, LLCAs reported in NPPES

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

Authorized official

Name

Michelle D Meer

Title

Vice President & Secretary

Phone

(629) 626-0000

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1278115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1510099200000",
    "number": "1871805010",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 COBBLESTONE TRCE SE",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317887747",
            "telephone_number": "229-985-3637",
            "fax_number": "229-985-3271"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 COBBLESTONE TRCE SE",
            "city": "MOULTRIE",
            "state": "GA",
            "postal_code": "317887747",
            "telephone_number": "229-985-3637",
            "fax_number": "229-985-3271"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COBBLESTONE REHABILITATION AND HEALTHCARE CENTER, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OLIVE LEAF, LLC",
        "enumeration_date": "2010-07-03",
        "last_updated": "2017-11-08",
        "status": "A",
        "authorized_official_last_name": "MEER",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "VICE PRESIDENT & SECRETARY",
        "authorized_official_telephone_number": "629-626-0000"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000142711A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alesia R Christian, LCSW
• Anthony Nicholas Cimmino, MD
• Shanta Lacole Clayton, RN
• Clubview Emergency Physicians
• Terry Lamar Cobb
• Annissa Vernita Collins
• Genise Collins
• Colquitt Chiropractic, LP
• Colquitt County Board of Education
• Colquitt County Board of Health

• Skilled Nursing Facility in Moultrie, GA
• Providers in Moultrie, GA by specialty
• Skilled Nursing Facility in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2017; 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.