Organization Active NPI

Optimum Health Rehab of Hiram LLC

  • General Practice Physician
  • Hiram, GA
National Provider Identifier
1982010732
Registry record updated Apr 11, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
Legal business name
OPTIMUM HEALTH REHAB OF HIRAM LLC
Practice address
47 Highland Pavilion CT Ste 102
Hiram, GA 30141-4119
Phone
(770) 439-6997
Fax
(770) 439-0997
NPI assigned
Jul 1, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2016

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

Authorized official

Name
Monica Shelton
Title
Operations MGR
Phone
(678) 730-6240

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193200000X MULTI-SPECIALTY GROUP 111N00000X
General Practice PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208D00000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X

Addresses

Primary practice location

47 Highland Pavilion CT Ste 102
Hiram, GA 30141-4119

Mailing address

2133 Highway 317 Ste 12-318
Suwanee, GA 30024-2649
Phone (678) 730-6240

Other names 1

  • Optimum Health Hiram LLC Doing business as

National Provider Directory

National Provider Directory

Locations

47 Highland Pavilion Ct
Ste 102
Hiram, GA 30141
Phone (770) 439-6997

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": "1404172800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460332800000",
    "number": "1982010732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2133 HIGHWAY 317 STE 12-318",
            "city": "SUWANEE",
            "state": "GA",
            "postal_code": "300242649",
            "telephone_number": "678-730-6240",
            "fax_number": "678-730-0280"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "47 HIGHLAND PAVILION CT STE 102",
            "city": "HIRAM",
            "state": "GA",
            "postal_code": "301414119",
            "telephone_number": "770-439-6997",
            "fax_number": "770-439-0997"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OPTIMUM HEALTH REHAB OF HIRAM LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-07-01",
        "last_updated": "2016-04-11",
        "status": "A",
        "authorized_official_last_name": "SHELTON",
        "authorized_official_first_name": "MONICA",
        "authorized_official_title_or_position": "OPERATIONS MGR",
        "authorized_official_telephone_number": "678-730-6240"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "General Practice",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Optimum Health Hiram LLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Hiram, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2016; 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.