REHABILITATION CENTER OF SOUTH GEORGIA, LLC
NPI 1073864286
Skilled Nursing Facility in Tifton, GA

Active since September 27, 2012CLIA 11D2057958 · Waiver
2002 TIFT AVE N, TIFTON, GA 31794(229) 382-7342 Get Directions Write a Review

NPPES record last updated: September 27, 2012. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Rehabilitation Center Of South Georgia, Llc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

REHABILITATION CENTER OF SOUTH GEORGIA, LLC (NPI 1073864286) is a healthcare organization registered as a skilled nursing facility in Tifton, Georgia and active in the NPI registry since September 2012. The organization holds a CLIA Waiver certificate valid through April 25, 2027 and lists William C Davis, Manager, as its authorized official.

NPPES Registry Identity

NPI1073864286
Entity TypeOrganization
Primary Taxonomy314000000X
Legal Business NameREHABILITATION CENTER OF SOUTH GEORGIA, LLC
Location Address2002 TIFT AVE NTifton, GA 31794-1824
Mailing Address2002 Tift Ave NTifton, GA 31794-1824 · (229) 382-7342
Organization SubpartNo
Authorized OfficialWilliam C DavisManager · (478) 988-1294
Enumeration DateSeptember 27, 2012
NPI 1073864286 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtySkilled Nursing FacilityNursing & Custodial Care Facilities
Taxonomy Code314000000X
Definition
(1) A skilled nursing facility is a facility or distinct part of an institution whose primary function is to provide medical, continuous nursing, and other health and social services to patients who are not in an acute phase of illness requiring services in a hospital, but who require primary restorative or skilled nursing services on an inpatient basis above the level of intermediate or custodial care in order to reach a degree of body functioning to permit self care in essential daily living. It meets any licensing or certification standards et forth by the jurisdiction where it is located. A skilled nursing facility may be a freestanding facility or part of a hospital that has been certified by Medicare to admit patients requiring subacute care and rehabilitation; (2) Provides non-acute medical and skilled nursing care services, therapy and social services under the supervision of a licensed registered nurse on a 24-hour basis.
2002 TIFT AVE N, Tifton, GA 31794

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 11D2057958

Rehabilitation Center Of South Georgia · Tifton, GA
Active · expires Apr 25, 2027
CLIA Number11D2057958
Laboratory TypeSkilled Nursing Facility/Nursing Facility
Certificate Effective DateApril 26, 2025
Certificate Expiration DateApril 25, 2027
Laboratory DirectorAppavuchetty J. Soundappan
Laboratory Phone(229) 382-7342
Laboratory LocationRehabilitation Center Of South Georgia2002 Tift Avenue, N, Tifton, GA 31794
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 3

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Skilled Nursing Facility
2002 TIFT AVE N
TIFTON, GA 31794
Physical Therapist
2002 TIFT AVE N
TIFTON, GA 31794
Skilled Nursing Facility
2002 TIFT AVE N
TIFTON, GA 31794

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Rehabilitation Center Of South Georgia, LLC's NPI number?

The NPI number for Rehabilitation Center Of South Georgia, LLC is 1073864286. It was assigned to this organization in the NPPES registry on September 27, 2012.

Where is Rehabilitation Center Of South Georgia, LLC located?

Rehabilitation Center Of South Georgia, LLC is located at 2002 Tift Ave N, Tifton, GA 31794. The listed phone number is (229) 382-7342.

What is Rehabilitation Center Of South Georgia, LLC's specialty?

The primary specialty registered for this NPI is Skilled Nursing Facility with taxonomy code 314000000X.

Does Rehabilitation Center Of South Georgia, LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 11D2057958) is associated with this NPI, valid through April 25, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Rehabilitation Center Of South Georgia, LLC was last updated on September 27, 2012. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.