NPIMap

Organization Active NPI

Georgia Neurology and Rehab

  • Specialist
  • Brunswick, GA
National Provider Identifier
1912003401
Registry record updated Nov 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
Legal business name
GEORGIA NEUROLOGY AND REHAB
Doing business as
Coastal Neurological Institute
Practice address
1111 Glynco Parkway
Suite 400
Brunswick, GA 31525
Phone
(912) 265-1357
Fax
(912) 265-0495
NPI assigned
Sep 15, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2011

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

Authorized official

Name
Dr. Carl T Shenkman, M.DNPI 1083664874
Title
Ceo
Phone
(912) 265-1357

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X Primary
SpecialistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 174400000X 036000 GA

Addresses

Primary practice location

1111 Glynco Parkway
Suite 400
Brunswick, GA 31525

Mailing address

1111 Glynco Parkway
Suite 400
Brunswick, GA 31525
Phone (912) 265-1357

Other identifiers 2

IdentifierTypeStateIssuer
DC7432OtherGARAILROAD MEDICARE PIN
000516942HMedicaidGA

Other names 1

  • Coastal Neurological Institute Doing business as

National Provider Directory

National Provider Directory

Locations

141 SE Broad St
Jesup, GA 31546
Phone (912) 265-1357

Practitioners & affiliated clinicians

Practitioners 4

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": "1158278400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1320278400000",
    "number": "1912003401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 GLYNCO PARKWAY",
            "address_2": "SUITE 400",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "31525",
            "telephone_number": "912-265-1357",
            "fax_number": "912-265-0495"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 GLYNCO PARKWAY",
            "address_2": "SUITE 400",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "31525",
            "telephone_number": "912-265-1357",
            "fax_number": "912-265-0495"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGIA NEUROLOGY AND REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-15",
        "last_updated": "2011-11-03",
        "status": "A",
        "authorized_official_last_name": "SHENKMAN",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "912-265-1357",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "036000",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PIN",
            "identifier": "DC7432",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000516942H",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Coastal Neurological Institute",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Brunswick, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2011; 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.