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ST. MARY SPINE AND SPORT INJURIES REHAB
NPI 1992479596
Internal Medicine in Bloomingdale, GA

Active since August 06, 2021
502 E US HIGHWAY 80 STE D, BLOOMINGDALE, GA 31302(912) 999-7275(912) 988-3748 Get Directions Write a Review

NPPES record last updated: May 30, 2024. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 23, 2021, Oct 14, 2021, Aug 19, 2021 and 1 more (4 updates tracked since 2021).

About St. Mary Spine And Sport Injuries Rehab NPPES

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

ST. MARY SPINE AND SPORT INJURIES REHAB (NPI 1992479596) is a healthcare organization registered as an internal medicine in Bloomingdale, Georgia and active in the NPI registry since August 2021. The organization maintains a secondary practice location in Pooler and lists Noha Raouf Soliman, Provider/owner, as its authorized official.

NPPES Registry Identity

NPI1992479596
Entity TypeOrganization
Primary Taxonomy207R00000X
Legal Business NameST. MARY SPINE AND SPORT INJURIES REHAB
Location Address502 E US HIGHWAY 80 STE DBloomingdale, GA 31302-9356
Mailing Address502 E Us Highway 80 Ste DBloomingdale, GA 31302-9356
Phone(912) 999-7275
Fax(912) 988-3748
Organization SubpartNo
Authorized OfficialNoha Raouf SolimanProvider/owner · (912) 508-8828
Enumeration DateAugust 6, 2021
Last NPPES UpdateMay 30, 20244 updates tracked since enumeration
NPPES CertifiedMay 30, 2024
✔ NPI 1992479596 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207R00000X
Definition
A physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs.
Also ListedPhysical TherapistTaxonomy 225100000X
502 E US HIGHWAY 80 STE D, Bloomingdale, GA 31302
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Secondary Practice Location 1

Location 152 Traders WayPooler, GA 31322-4158 · Phone (912) 999-7275

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment, revalidation and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

St. Mary Spine And Sport Injuries Rehab is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Revalidation Due Date

Revalidation due by December 31, 2026

Medicare-enrolled providers and suppliers confirm their enrollment information with CMS on a set cycle, every 5 years for most and every 3 years for medical equipment suppliers. CMS sets the due date for each enrollment.

StateEnrollment IDDue date
StateGeorgiaEnrollment IDO20211201002888Non-DME Part B · Clinic/Group PracticeDue dateDecember 31, 2026
Source: CMS Revalidation Due Date List, October 2026 release.

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to St. Mary Spine And Sport Injuries Rehab, which bills Medicare for the services this clinician delivers.

Clinician (1)

Noha Soliman
Internal Medicine
NPI 1023066206
502 E US HIGHWAY 80 STE D
Bloomingdale, GA 31302
(912) 999-7275
✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 St. Mary Spine And Sport Injuries Rehab's NPI number?

The NPI number for St. Mary Spine And Sport Injuries Rehab is 1992479596. It was assigned to this organization in the NPPES registry on August 6, 2021.

Where is St. Mary Spine And Sport Injuries Rehab located?

St. Mary Spine And Sport Injuries Rehab is located at 502 E Us Highway 80 Ste D, Bloomingdale, GA 31302. The listed phone number is (912) 999-7275.

What is St. Mary Spine And Sport Injuries Rehab's specialty?

The primary specialty registered for this NPI is Internal Medicine with taxonomy code 207R00000X.

Is St. Mary Spine And Sport Injuries Rehab enrolled in Medicare?

Yes. St. Mary Spine And Sport Injuries Rehab is registered in the Medicare PECOS enrollment system.

When is St. Mary Spine And Sport Injuries Rehab's Medicare revalidation due?

According to the CMS Revalidation Due Date List (October 2026 release), the Medicare Non-DME Part B enrollment for this organization (Georgia, Clinic/Group Practice) is due for revalidation by December 31, 2026. Medicare providers and suppliers revalidate their enrollment every 5 years, and medical equipment suppliers every 3 years. Confirm current requirements with your Medicare Administrative Contractor.

How many clinicians bill Medicare through St. Mary Spine And Sport Injuries Rehab?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Internal Medicine) reassigns their Medicare billing to St. Mary Spine And Sport Injuries Rehab. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for St. Mary Spine And Sport Injuries Rehab was last updated on May 30, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.