NPIMap

Organization Active NPI

Spinal Rehab and Healthcare, LLC

Doing business as Spinal Rehab and Healthcare

  • Family Medicine Physician
  • Cornelia, GA
National Provider Identifier
1962817957
Registry record updated Nov 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
SPINAL REHAB AND HEALTHCARE, LLC
Doing business as
Spinal Rehab and Healthcare
Practice address
186 Cannon Bridge Rd
Suite B
Cornelia, GA 30531-4700
Phone
(706) 778-0077
NPI assigned
Jun 27, 2014
Last updated
Nov 10, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 10, 2014

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

Authorized official

Name
Courtnery Allen Mote, DC
Title
Owner
Phone
(706) 778-0077

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

186 Cannon Bridge Rd
Suite B
Cornelia, GA 30531-4700

Mailing address

186 Cannon Bridge Rd
Suite B
Cornelia, GA 30531-4700
Phone (706) 778-0077

Other names 1

  • Spinal Rehab and Healthcare Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20140917002828 GA Part B Supplier - Clinic/Group Practice 5294954624 Receives reassigned benefits from 11 practitioners
Practice locations: Cornelia, GA
O20170620000391 GA DME Supplier - Multi-Specialty - Physician 5294954624 Practice locations: Cornelia, GA

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
11D2091551Spinal Rehab and Healthcare, LLC186 Cannon Bridge Rd, Ste B, Cornelia, GA 30531Certificate of waiverFeb 16, 2027

National Provider Directory

National Provider Directory

Locations

186 Cannon Bridge Rd
Cornelia, GA 30531

Practitioners & affiliated clinicians

Practitioners 12

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.

NPI Registry JSON

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

{
    "created_epoch": "1403827200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1415577600000",
    "number": "1962817957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "186 CANNON BRIDGE RD",
            "address_2": "SUITE B",
            "city": "CORNELIA",
            "state": "GA",
            "postal_code": "305314700",
            "telephone_number": "706-778-0077"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "186 CANNON BRIDGE RD",
            "address_2": "SUITE B",
            "city": "CORNELIA",
            "state": "GA",
            "postal_code": "305314700",
            "telephone_number": "706-778-0077"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPINAL REHAB AND HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-06-27",
        "last_updated": "2014-11-10",
        "status": "A",
        "authorized_official_last_name": "MOTE",
        "authorized_official_first_name": "COURTNERY",
        "authorized_official_middle_name": "ALLEN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "706-778-0077",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Spinal Rehab and Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Cornelia, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 10, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.