KENNESTONE HOSPITAL, INC (NPI# 1578553343) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578553343 |
| Entity Type | Organization |
| Organization Name | KENNESTONE HOSPITAL, INC |
| Other Organization Name | WELLSTAR KENNESTONE HOSPITAL INPATIENT REHAB UNIT |
| Practice Address |
677 Church St Ne Inpatient Rehab Unit/6 West Marietta GA 30060-1101 |
| Mailing Address |
1800 Parkway Pl Se Ste 500 Marietta GA 30067-8237 |
| Practice Telephone | 4706440012 |
| Practice Fax Number | 7707937939 |
| Mailing Telephone | 4709564981 |
| Mailing Fax Number | 7709992489 |
| Enumeration Date | 2005-10-24 |
| Last Update Date | 2020-02-24 |
| Authorized Official Name | MR. ANTHONY J BUDZINSKI (EVP & CHIEF FINANCIAL OFFICER) |
| Authorized Official Telephone | 4706440012 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 273Y00000X | Rehabilitation Unit | 033-548 | GA | Hospital Units |
| Y | 273Y00000X | Rehabilitation Unit | GA | Hospital Units |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 000001119A | 05 |
| Other Name | Type Code |
|---|---|
| WellStar Kennestone Hospital Inpatient Rehab Unit | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386943009 | Kennestone Hospital, Inc | Pharmacy | 3950 Austell Rd, Suite 8, Austell, GA 30106-1121 | 2011-03-21 |
| Street Address |
677 CHURCH ST NE INPATIENT REHAB UNIT/6 WEST |
| City | MARIETTA |
| State | GA |
| Zip Code | 30060-1101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841285095 | Grace S Kim | Anesthesiology | 677 Church St Ne, Marietta, GA 30060-1101 | 2005-09-14 |
| 1205436425 | Lakesha Alexis | Nurse Practitioner | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-10-27 |
| 1710594080 | Terrence Helms | Nurse Anesthetist, Certified Registered | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-09-30 |
| 1063022481 | Laura Elliott | Registered Nurse | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-08-01 |
| 1346868908 | Megan Grace Zimmerman | Anesthesiologist Assistant | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-07-10 |
| 1578180535 | Devon Potler-jack | Anesthesiologist Assistant | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-06-25 |
| 1740802032 | Noelle Shaw | Anesthesiologist Assistant | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-05-11 |
| 1316567860 | Molly O'keeffe | Registered Nurse | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-04-24 |
| 1740800317 | Sara Roberts | Registered Nurse | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-04-23 |
| 1508486184 | Luke Bishop | Student in an Organized Health Care Education/Training Program | 677 Church St Ne, Marietta, GA 30060-1101 | 2020-04-23 |
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|---|---|---|---|---|
| 1144845116 | Legacy Center for Spinal Surgery, LLC | Neurological Surgery | 1900 The Exchange, Ne, Suite 600, Marietta, GA 30060 | 2020-06-15 |
| 1407477193 | Michael Cynil Daniel | Counselor | 698 N Marietta, Pkwy, Marietta, GA 30060 | 2020-05-04 |
| 1285253401 | Cameron Thomas Kennelly | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne Attn:gme, Marietta, GA 30060 | 2020-04-09 |
| 1922640739 | Jeremiah George Blair | Physician Assistant | 61 Whitcher St Suite 2100, Marietta, GA 30060 | 2019-10-14 |
| 1164064945 | Denise Alicia Mick | Registered Nurse | 677 Church St Wellstar Kennestone Hospital, Marietta, GA 30060 | 2019-10-12 |
| 1184283772 | Iora Health Georgia, P.C. | Internal Medicine | 280 Cobb Pkwy Se, Suite 60, Marietta, GA 30060 | 2019-06-07 |
| 1346703212 | Caitlin Virginia Mueller | Student in an Organized Health Care Education/Training Program | 677 Church Street Ne, Attn: Gme, Marietta, GA 30060 | 2019-04-08 |
| 1184187205 | Adero Francis | Student in an Organized Health Care Education/Training Program | Wellstar Kennestone Gme Internal Medicine Clinic, 833 Campbell Hill St Nw, Suite 250, Marietta, GA 30060 | 2019-04-08 |
| 1659832749 | Matthew Mozzo | Student in an Organized Health Care Education/Training Program | 677 Church Street / Lower Level, Gme Department / I.m., Marietta, GA 30060 | 2019-03-29 |
| 1245797430 | La'myia Spentz | Specialist | 109 Anderson St Ne, Suite 608, Marietta, GA 30060 | 2019-02-25 |
| Find all providers in zip 30060 | ||||
| Taxonomy Code | 273Y00000X |
| Grouping | Hospital Units |
| Classification | Rehabilitation Unit |
| In general, a distinct unit of a general acute care hospital that provides care encompassing a comprehensive array of restoration services for the disabled and all support services necessary to help patients attain their maximum functional capacity. Source: AHA Annual Survey p. A10 1996 AHA Guide. For Medicare, a distinct part of a general acute care hospital providing inpatient rehabilitation services that meets the following requirements. Rehabilitation Units have in effect a preadmission screening procedure under which each prospective patient’s condition and medical history are reviewed to determine whether the patient is likely to benefit significantly from an intensive inpatient program or assessment; ensure that the patients receive close medical supervision and furnish, through the use of qualified personnel, rehabilitation nursing, physical therapy and occupational therapy, plus, as needed, speech therapy, social services or psychological services and orthotic and prosthetic services; have a plan of treatment for each inpatient that is established, reviewed, and revised as needed by a physician in consultation with other professional personnel who provide services to the patient; use a coordinated multidisciplinary team approach in the rehabilitation of each inpatient, as documented by periodic clinical entries made in the patient’s medical record to note the patient's status in relationship to goal attainment, and that team conferences are held at least every two weeks to determine the appropriateness of treatment; have a director of rehabilitation who provides services to the unit and its inpatients for at least 20 hours a week, is a doctor of medicine or osteopathy, is licensed under State law to practice medicine or surgery, and has had, after completing a one-year hospital internship at least two years of training or experience in the medical management of inpatients requiring rehabilitation services. |
| Notes: Source: Code of Federal Regulations #42, Section 412.29. |
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| 1497135412 | Selby General Hospital | Rehabilitation Unit | 1106 Colegate Dr, Marietta, OH 45750-1323 | 2015-06-04 |
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| 1316456825 | Children's Healthcare of Atlanta At Scottish Rite | Rehabilitation Unit | 605 Big Shanty Road, Nw, Ste 100, Kennesaw, GA 30144-3646 | 2017-09-27 |
| 1386177798 | Southeast Georgia Health Services, L.L.C. | Rehabilitation Unit | 2500 Satilla Pkwy, Waycross, GA 31503-8852 | 2017-04-04 |
| 1578996245 | Complete Healthcare Management LLC | Rehabilitation Unit | 1060 Deer Chase, Stone Mountain, GA 30088-2404 | 2013-08-16 |
| 1306197702 | Children's Healthcare of Atlanta | Rehabilitation Unit | 2270 Duluth Hwy, Duluth, GA 30097-4010 | 2012-09-25 |
| 1497035489 | Body Mechanics Rehabilitation Services, LLC | Rehabilitation Unit | 524 New River Way, Mcdonough, GA 30252-4153 | 2011-08-22 |
| 1598990376 | Phoebe Sumter Medical Center, Inc. | Rehabilitation Unit | 126 Hwy 280 W, Americus, GA 31719-8645 | 2009-05-21 |
| 1124295274 | Va Medical Center-downtown Division/augusta | Rehabilitation Unit | 3336 Thames Pl, Hephzibah, GA 30815-7176 | 2008-05-08 |
| 1942412754 | Calhoun Memorial Hospital | Rehabilitation Unit | 103 R E Jennings Ave, Arlington, GA 39813 | 2007-05-04 |
| 1134168016 | Northside Hospital, Inc. | Rehabilitation Unit | 3215 Mcclure Bridge Rd, Duluth, GA 30096-3223 | 2006-06-06 |
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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.