Ideal Therapy Rehabilitative Services II, LLC

Primary specialty

Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X

Legal business name

IDEAL THERAPY REHABILITATIVE SERVICES II, LLC

Doing business as

Ideal Therapy II

Practice address

6572 River Park Dr Ste 101
Riverdale, GA 30274-2214

Phone

(678) 626-1833

Fax

(678) 626-1844

NPI assigned

Oct 1, 2019

Organization subpart

No

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

Authorized official

Name

Samson Saint-RemyNPI 1043701162

Title

Ceo

Phone

(678) 626-1833

Specialties & licenses 3

Addresses

Other names 1

• Ideal Therapy II Doing business as

Medicare fee-for-service enrollment

Enrolled in GA

Enrollment records 1

Locations

Practitioners 1

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

• Samson Saint-Remy, OTR/L

  • Occupational Therapist
  • Riverdale, GA
  • NPI 1043701162
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1569888000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1732579200000",
    "number": "1912548959",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6572 RIVER PARK DR STE 101",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742214",
            "telephone_number": "678-626-1833",
            "fax_number": "678-626-1844"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6572 RIVER PARK DR STE 101",
            "city": "RIVERDALE",
            "state": "GA",
            "postal_code": "302742214",
            "telephone_number": "678-626-1833",
            "fax_number": "678-626-1844"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IDEAL THERAPY REHABILITATIVE SERVICES II, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-10-01",
        "last_updated": "2024-11-26",
        "certification_date": "2024-11-26",
        "status": "A",
        "authorized_official_last_name": "SAINT-REMY",
        "authorized_official_first_name": "SAMSON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "678-626-1833"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ideal Therapy II",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ideal Therapy II",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Multi-Specialty Clinic/Center in Riverdale, GA
• Providers in Riverdale, GA by specialty
• Multi-Specialty Clinic/Center in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2024; 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.