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Cedar Grove Rehab LLC

Physical Medicine & Rehabilitation Physician in Ellenwood, GA · enumerated 2013 · authorized official Otis Bonner, Attorney.

Data current as of Jul 13, 2026 · sourced from CMS NPPES

National Provider Identifier

1255776613

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Registry record

Entity type Organization (Type 2)
Legal business name Cedar Grove Rehab LLC
Practice address 3395 Bouldercrest Rd, Ellenwood, GA, 30294
Phone (404) 241-3280
Enumeration date Apr 30, 2013
Last updated in NPPES Apr 30, 2013

Taxonomy & classification

111N00000X Chiropractor Chiropractic Providers Secondary
208100000X Physical Medicine & Rehabilitation Physician Allopathic & Osteopathic Physicians Primary
363A00000X Physician Assistant Physician Assistants & Advanced Practice Nursing Providers Secondary

Authorized official

Name Otis Bonner
Title Attorney
Phone (770) 940-4975

What is an NPI number?

A National Provider Identifier (NPI) is a unique 10-digit number that CMS assigns to every U.S. healthcare provider and organization under HIPAA. Type 1 NPIs identify individual providers; Type 2 NPIs identify organizations. The NPI appears on insurance claims, prescriptions, and credentialing paperwork, and never changes, even if the provider moves or changes specialty.

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Frequently asked questions

What type of organization is Cedar Grove Rehab LLC?
Cedar Grove Rehab LLC is registered in NPPES as a Physical Medicine & Rehabilitation Physician (its primary provider taxonomy).
What is a Type 2 NPI?
A Type 2 NPI identifies an organization (group practice, hospital, pharmacy, lab), while Type 1 NPIs identify individual providers. Organizations bill under their Type 2 NPI.

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Source: CMS NPPES (public data). Snapshot 2026-07-13. Provider record last updated 2013-04-30.