SOUTHERN REHAB AND SPORTS MEDICINE, INC. (NPI# 1215167515) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215167515 |
| Entity Type | Organization |
| Organization Name | SOUTHERN REHAB AND SPORTS MEDICINE, INC. |
| Practice Address |
1805 Vernon Rd Suite A Lagrange GA 30240-3871 |
| Practice Telephone | 7068459383 |
| Practice Fax Number | 7068459482 |
| Mailing Telephone | 7068459383 |
| Mailing Fax Number | 7068459482 |
| Enumeration Date | 2009-07-21 |
| Last Update Date | 2015-11-04 |
| Authorized Official Name | DR. JOSHUA D MCGINTY (VICE PRESIDENT, PHYSICAL THERAPIST) |
| Authorized Official Telephone | 7068459383 |
| Authorized Official Credential | DPT, ATC |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 332B00000X | Durable Medical Equipment & Medical Supplies | GA | Suppliers | |
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
8954 | GA | Ambulatory Health Care Facilities |
| Street Address |
1805 VERNON RD SUITE A |
| City | LAGRANGE |
| State | GA |
| Zip Code | 30240-3871 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376543736 | Deborah A Simmons | Anesthesiology | 1805 Vernon Rd, Suite C, Lagrange, GA 30240-4041 | 2005-07-28 |
| 1144507864 | Haley Alicia Egesdahl | Physical Therapist | 1805 Vernon Rd, Ste A, Lagrange, GA 30240-3871 | 2011-11-09 |
| 1285912600 | The Emory Clinic | Clinic/Center | 1805 Vernon Rd, Suite C, Ambulatory Surgery Center, Lagrange, GA 30240-3871 | 2011-08-02 |
| 1295034551 | Tomas Kuprys | Internal Medicine | 1805 Vernon Rd, Lagrange, GA 30240-3871 | 2011-03-24 |
| 1265674402 | Pamela G Miller | Nurse Anesthetist, Certified Registered | 1805 Vernon Rd, Suite C, Lagrange, GA 30240-3871 | 2009-04-02 |
| 1851544795 | Laura Leigh Smith | Physical Therapist | 1805 Vernon Rd, Suite A, Lagrange, GA 30240-3871 | 2008-10-23 |
| 1639326994 | Southern Surgery Center LLC | Anesthesiology | 1805 Vernon Rd, Suite C, Lagrange, GA 30240-3871 | 2008-08-19 |
| 1629279898 | Angie Carver | Physical Therapist | 1805 Vernon Rd, Suite A, Lagrange, GA 30240-4041 | 2007-05-29 |
| 1881723682 | Beth Ann Pendergraph | Physician Assistant | 1805 Vernon Rd, Suite B, Lagrange, GA 30240-3871 | 2007-03-05 |
| 1942337159 | Joshua D. Mcginty | Orthotic Fitter | 1805 Vernon Rd, Suite A, Lagrange, GA 30240-4041 | 2007-02-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598223844 | Urgencare, LLC | Clinic/Center | 2169 West Point Road, Suite 105, Lagrange, GA 30240 | 2019-03-06 |
| 1679075527 | Georgia Pain and Spine Care, Inc | Pain Medicine | 303 Smith St Fl 2, Lagrange, GA 30240 | 2018-03-07 |
| 1629463500 | Quoc Vinh Ngo | Emergency Medicine | Wellstar West Georgia Medical Center, 1504 Vernon Road, Lagrange, GA 30240 | 2015-03-30 |
| 1770913964 | Dell H Lawson | Counselor | 300 Medical Dr. Ste 705., Lagrange, GA 30240 | 2013-11-25 |
| 1629418793 | Mortar & Pestle, LLC | Pharmacy | 205 Vernon Street, Lagrange, GA 30240 | 2013-07-03 |
| 1336582329 | Weredeselam Menna Olango | Psychiatry & Neurology | 303 Medical Dr Ste 401, Lagrange, GA 30240 | 2013-04-10 |
| 1720333743 | Mortar and Pestle, LLC | Pharmacy | 300 Mooty Bridge Road, Lagrange, GA 30240 | 2012-07-16 |
| 1366768459 | Karin Taylor | Physical Medicine & Rehabilitation | 1600 Vernon Rd Ste A, Lagrange, GA 30240 | 2010-04-14 |
| 1871819458 | Kathryn J Hill | Counselor | 100 Smith St Ste 1, Lagrange, GA 30240 | 2010-04-08 |
| 1285802751 | Air Evac Ems, Inc. | Ambulance | 455 Aerotron Pkwy, Lagrange, GA 30240 | 2008-02-18 |
| Find all providers in zip 30240 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174605307 | Southern Therapy Services, Inc. | Clinic/Center | 1805 Vernon Rd, Suite A, Lagrange, GA 30240-4041 | 2006-10-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982205159 | Thrive Therapy and Wellness Services LLC | Clinic/Center | 106 Mims Rd, Sylvania, GA 30467-1995 | 2020-11-04 |
| 1851990063 | On The Move Massage & Physical Therapy | Clinic/Center | 7454 Silver Arrow Trl, Austell, GA 30168-2401 | 2020-10-19 |
| 1659979086 | Mvp Physio Dr. | Clinic/Center | 123 Umiya Nagar Cir, Macon, GA 31206-5401 | 2020-10-16 |
| 1972100865 | Resilient Physio, LLC | Clinic/Center | 790 West Ave, Cartersville, GA 30120-3402 | 2020-10-05 |
| 1205441987 | Fortitude Movement & Strength Inc. | Clinic/Center | 5300 Peachtree Rd Unit 2508, Atlanta, GA 30341-2457 | 2020-09-10 |
| 1376151001 | Mother and Baby Wellness Collective, LLC | Clinic/Center | 136 Millstone Way, Canton, GA 30115-7270 | 2020-07-20 |
| 1225646821 | Innovative Therapeutic Solutions, LLC | Clinic/Center | 360 Pharr Rd Ne Apt 404, Atlanta, GA 30305-2391 | 2020-07-20 |
| 1669090544 | Active Body Physiotherapy | Clinic/Center | 2968 Ask Kay Dr Se Ste B, Smyrna, GA 30082-2304 | 2020-07-08 |
| 1487270914 | Docjay Physical Therapy | Clinic/Center | 6740 Shannon Pkwy Ste 14, Union City, GA 30291-2061 | 2020-06-20 |
| 1477176923 | R & J Health Care | Clinic/Center | 6853b Douglas Blvd Ste B, Douglasville, GA 30135 | 2020-05-19 |
| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.