FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC (NPI# 1568970887) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568970887 |
| Entity Type | Organization |
| Organization Name | FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC |
| Other Organization Name | AGEILITY PHYSICAL THERAPY SOLUTIONS AT GRACEMONT |
| Practice Address |
4960 Jot Em Down Rd Cumming GA 30041-3004 |
| Practice Telephone | 7708872000 |
| Practice Fax Number | 7708872800 |
| Mailing Telephone | 7708872000 |
| Mailing Fax Number | 7708872800 |
| Enumeration Date | 2018-01-22 |
| Last Update Date | 2020-07-01 |
| Authorized Official Name | KATHERINE E POTTER (PRESIDENT & CHIEF EXECUTIVE OFFICER) |
| Authorized Official Telephone | 6177968387 |
| Is Organization Subpart | Y |
| Parent Organization Name | FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
GA | Ambulatory Health Care Facilities |
| Other Name | Type Code |
|---|---|
| Ageility Physical Therapy Solutions at Gracemont | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669980983 | Five Star Rehabilitation and Wellness Services, LLC | Clinic/Center | 900 West Lake Road, Palm Harbor, FL 34684-3142 | 2018-01-22 |
| 1275044158 | Five Star Rehabilitation and Wellness Services, LLC | Clinic/Center | 7410 Skidaway Rd, Savannah, GA 31406-6446 | 2017-10-18 |
| 1497274997 | Five Star Rehabilitation and Wellness Services, LLC | Clinic/Center | 10914 Kingston Pike, Knoxville, TN 37934-2944 | 2017-09-15 |
| 1144356759 | Five Star Rehabilitation and Wellness Services, LLC | Clinic/Center | 269 Stevens St, Hyannis, MA 02601-3740 | 2007-02-26 |
| 1760959993 | Five Star Rehabilitation and Wellness Services, LLC | Clinic/Center | 3501 N Highway 81, Anderson, SC 29621-4419 | 2018-10-25 |
| 1063923944 | Five Star Rehabilitation and Wellness Services, LLC | Clinic/Center | 6001 E Thomas Rd, Scottsdale, AZ 85251-7511 | 2017-10-18 |
| 1235640111 | Five Star Rehabilitation and Wellness Services, LLC | Clinic/Center | 24552 Paseo De Valencia, Laguna Hills, CA 92653-4236 | 2017-10-18 |
| 1134630015 | Five Star Rehabilitation and Wellness Services, LLC | Clinic/Center | 1250 W Central Rd, Arlington Heights, IL 60005-2489 | 2017-10-18 |
| 1265943146 | Five Star Rehabilitation and Wellness Services, LLC | Clinic/Center | 8151 E Speedway Blvd, Tucson, AZ 85710-3323 | 2017-10-18 |
| 1255854592 | Five Star Rehabilitation and Wellness Services, LLC | Clinic/Center | 2744 S 17th St, Wilmington, NC 28412-6606 | 2017-07-19 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| Colorado Business Entities | Five Star Rehabilitation and Wellness Services, LLC | 400 Centre Street, Newton, MA 02458 |
| Massachusetts Corporations | FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC | 400 Centre St., Newton, MA 02458 |
| Washington State Corporations | FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC | 400 Centre St, Newton, MA 02458-2094 |
| Oregon Corporations, Companies and Business Names | FIVE STAR REHABILITATION AND WELLNESS SERVICES, LLC | 400 Centre St, Newton, MA 02458 |
| Street Address |
4960 JOT EM DOWN RD |
| City | CUMMING |
| State | GA |
| Zip Code | 30041-3004 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962036905 | Annie Kyungjin Han | Nurse Practitioner | 1505 Northside Forsyth Drive, Suite 2500, Cumming, GA 30041 | 2020-02-28 |
| 1295388197 | Pamela Edler | Pharmacist | 1200 Northside Forsyth Drive, Pharmacy Department, Cumming, GA 30041 | 2019-07-19 |
| 1720557127 | Dr. Tiffany Lamonde LLC | Physical Therapist | 1445 Haw Creek Circle, Suite 503, Cumming, GA 30041 | 2018-11-15 |
| 1487140893 | Bhbd LLC | Chiropractor | 425 Peachtree Parkway, Suite 315, Cumming, GA 30041 | 2018-07-09 |
| 1891219861 | Anna Gawrys | Pharmacist | 1525 Marketplace Blvd, Cumming, GA 30041 | 2017-08-01 |
| 1679029219 | Square One Dental LLC | Clinic/Center | 3510 Rowe Lane, Cumming, GA 30041 | 2016-09-01 |
| 1720441454 | Pavilion Psychological Services LLC | Psychologist | 1445 Haw Creek Corners Circle East, Suite 501, Cumming, GA 30041 | 2016-03-31 |
| 1346606506 | American Health Imaging of Ga, LLC | Clinic/Center | 1050 Haw Creek Pkwy, Suite 100, Cumming, GA 30041 | 2016-01-04 |
| 1013311307 | Stephen Hartle | Physician Assistant | 2576 Peachtree Pkwy, Suite 100, Cumming, GA 30041 | 2014-10-15 |
| 1063828408 | Stephanie Evans Wellborn | Physician Assistant | 1800 Northside Forsyth Dr Ste 450, Cumming, GA 30041 | 2014-07-07 |
| Find all providers in zip 30041 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326544297 | Sterling Sports Medicine & Physical Therapy, LLC | Clinic/Center | 1980 Daves Creek Trl, Cumming, GA 30041-6947 | 2018-03-31 |
| 1679093223 | Georgia Physical Therapy & Sports Medicine Center | Clinic/Center | 2 Tri County Plz, Cumming, GA 30040-2700 | 2017-06-26 |
| 1487073904 | North Georgia Therapy for Kids, LLC | Clinic/Center | 4655 Dahlonega Hwy, Cumming, GA 30028-3304 | 2014-04-11 |
| 1962824177 | Esop Rehabilitation, LLC | Clinic/Center | 565 Lakeland Plaza, Cumming, GA 30040-2784 | 2014-01-08 |
| 1265803118 | Clemons Physical Therapy, LLC | Clinic/Center | 4620 Poco Ct, Cumming, GA 30040-0458 | 2015-10-16 |
| 1033381561 | Cor II | Clinic/Center | 5610 Bethelview Rd, Suite 400, Cumming, GA 30040-7522 | 2008-03-25 |
| 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.