Cedar Grove Rehab LLC
NPI 1255776613 · Physical Medicine & Rehabilitation Physician · Ellenwood, GA
Cedar Grove Rehab LLC is a Physical Medicine & Rehabilitation Physician organization in Ellenwood, GA (NPI 1255776613).
Provider details
- NPI number
- 1255776613
- Entity type
- Organization
- Primary specialty
- Physical Medicine & Rehabilitation PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Otis Bonner, Attorney(770) 940-4975
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Chiropractor111N00000X
Chiropractic Providers
- Physician Assistant363A00000X
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
13 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
Mailing address
Registry dates
- Enumerated
- 2013-04-30
- Last updated
- 2013-04-30
Frequently asked questions
- What is Cedar Grove Rehab LLC's NPI number?
- Cedar Grove Rehab LLC's National Provider Identifier (NPI) is 1255776613, a unique 10-digit ID issued by CMS for use in standard healthcare transactions.
- What type of organization is Cedar Grove Rehab LLC?
- Cedar Grove Rehab LLC is classified in the NPPES registry as Physical Medicine & Rehabilitation Physician (Allopathic & Osteopathic Physicians).
- Where is Cedar Grove Rehab LLC located?
- Cedar Grove Rehab LLC's practice location on file with NPPES is 3395 Bouldercrest Rd, Ellenwood, GA 30294-1639.
- What is Cedar Grove Rehab LLC's phone number?
- The practice phone number listed in the NPPES registry for Cedar Grove Rehab LLC is (404) 241-3280.
- Who is the authorized official for Cedar Grove Rehab LLC?
- The authorized official listed on Cedar Grove Rehab LLC's NPPES record is Otis Bonner, Attorney. The authorized official registers and maintains the organization's NPI and is not necessarily its owner.
- Is Cedar Grove Rehab LLC's NPI active?
- Yes — Cedar Grove Rehab LLC's NPI (1255776613) is active in the NPPES registry as of the last update on 2013-04-30.
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.