Legacy Orthopedic Rehab LLC
Physical Therapist, Orthopedic in Newnan, GA. Organization (NPI-2).
NPI number1679264659
StatusActive
Last updated in NPPESMay 18, 2023
Details
- NPI
- 1679264659
- Entity type
- Organization (NPI-2)
- Legal business name
- Legacy Orthopedic Rehab LLC
- Organization subpart
- No
- Enumeration date
- May 18, 2023
- Certification date
- May 18, 2023
- Last updated
- May 18, 2023
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PART B SUPPLIER - PHYSICAL/OCCUPATIONAL THERAPY GROUP IN PRI
- Can order and refer
- Not on the CMS order and referring list
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 2251X0800X | Physical Therapist, Orthopedic | – | – | Yes |
Practice location
2462 Highway 34 E Ste ENewnan, GA 30265-2378
Phone 229-886-7400
Mailing address
165 Hickory Hills DrNewnan, GA 30263-6343
Phone 229-886-7400
Authorized official
Joshua Smith
Owner/Physical Therapist
2298867400
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