NPIMap

Organization Active NPI

Chimed Rehab South Atlanta, LLC

  • Primary Care Clinic/Center
  • Forest Park, GA
National Provider Identifier
1962081604
Registry record updated Jun 14, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
CHIMED REHAB SOUTH ATLANTA, LLC
Practice address
541 Forest Pkwy Ste 14
Forest Park, GA 30297-6110
Phone
(877) 495-7773
Fax
(866) 537-1711
NPI assigned
Apr 7, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2022

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

Authorized official

Name
Dr. Stephen B. Cooper, DC, FACMUAP
Title
Manager
Phone
(334) 298-7700

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WX0800X
Medical Specialty Clinic/Center 261QM2500X
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

541 Forest Pkwy Ste 14
Forest Park, GA 30297-6110

Mailing address

PO Box 1601
Phenix City, AL 36868-1601
Phone (334) 298-7700

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1617753600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1655164800000",
    "number": "1962081604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1601",
            "city": "PHENIX CITY",
            "state": "AL",
            "postal_code": "368681601",
            "telephone_number": "334-298-7700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 FOREST PKWY STE 14",
            "city": "FOREST PARK",
            "state": "GA",
            "postal_code": "302976110",
            "telephone_number": "877-495-7773",
            "fax_number": "866-537-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHIMED REHAB SOUTH ATLANTA, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-07",
        "last_updated": "2022-06-14",
        "certification_date": "2022-06-14",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "B.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "334-298-7700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC, FACMUAP"
    },
    "taxonomies": [
        {
            "code": "163WX0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Orthopedic",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Park, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2022; 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.