Provider Demographics
NPI:1407449168
Name:INTEGRITY REHAB MANAGEMENT
Entity Type:Organization
Organization Name:INTEGRITY REHAB MANAGEMENT
Other - Org Name:INTEGRITY DIAGNOSTICS
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER-MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:SHAWN
Authorized Official - Middle Name:
Authorized Official - Last Name:HUMPHRIES
Authorized Official - Suffix:
Authorized Official - Credentials:MPT, OCS, ECS
Authorized Official - Phone:706-329-5108
Mailing Address - Street 1:252 STRICKLAND PASTURE RD
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:GA
Mailing Address - Zip Code:30233-4019
Mailing Address - Country:US
Mailing Address - Phone:706-329-5108
Mailing Address - Fax:
Practice Address - Street 1:252 STRICKLAND PASTURE RD
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:GA
Practice Address - Zip Code:30233-4019
Practice Address - Country:US
Practice Address - Phone:706-329-5108
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-02-14
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2251N0400XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistNeurologyGroup - Multi-Specialty
No204R00000XAllopathic & Osteopathic PhysiciansElectrodiagnostic MedicineGroup - Multi-Specialty
No261QP2000XAmbulatory Health Care FacilitiesClinic/CenterPhysical TherapyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1609873454OtherCMS-NPPES