NPIMap

Organization Active NPI

Sensational Kids Pediatric Rehabilitation & Counseling, Inc.

  • Clinic/Center
  • Martinez, GA
National Provider Identifier
1962676502
Registry record updated Jan 6, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
SENSATIONAL KIDS PEDIATRIC REHABILITATION & COUNSELING, INC.
Practice address
3580 River Watch Pkwy
Martinez, GA 30907-3682
Phone
(706) 364-3470
Fax
(706) 364-3470
NPI assigned
Apr 15, 2008
Last updated
Jan 6, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 6, 2021

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

Authorized official

Name
Mr. Jordan Wiley Bowling
Title
President
Phone
(706) 364-3470

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X Primary

Addresses

Primary practice location

3580 River Watch Pkwy
Martinez, GA 30907-3682

Mailing address

3580 River Watch Pkwy
Martinez, GA 30907-3682
Phone (706) 364-3470

Other identifiers 1

IdentifierTypeStateIssuer
689380396AMedicaidGA

Other names 1

  • Sensational Kids Other name

National Provider Directory

National Provider Directory

Locations

3576 River Watch Pkwy
Martinez, GA 30907
Phone (706) 364-3470

3580 River Watch Pkwy
Martinez, GA 30907
Phone (706) 364-3470

Practitioners & affiliated clinicians

Practitioners 25

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 25

NPI Registry JSON

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

{
    "created_epoch": "1208217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609891200000",
    "number": "1962676502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3580 RIVER WATCH PKWY",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309073682",
            "telephone_number": "706-364-3470",
            "fax_number": "706-364-3470"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3580 RIVER WATCH PKWY",
            "city": "MARTINEZ",
            "state": "GA",
            "postal_code": "309073682",
            "telephone_number": "706-364-3470",
            "fax_number": "706-364-3470"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SENSATIONAL KIDS PEDIATRIC REHABILITATION & COUNSELING, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-04-15",
        "last_updated": "2021-01-06",
        "certification_date": "2021-01-06",
        "status": "A",
        "authorized_official_last_name": "BOWLING",
        "authorized_official_first_name": "JORDAN",
        "authorized_official_middle_name": "WILEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "706-364-3470",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "689380396A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sensational Kids",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Sensational Kids",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Martinez, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2021; 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.