Active NPI
Professional Rehabilitation Center Inc
- Physical Therapist
- Fargo, ND
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- Legal business name
- PROFESSIONAL REHABILITATION CENTER INC
- Practice address
- 4420 37TH Ave S
Fargo, ND 58104-3400 - Phone
- (701) 451-9417
- NPI assigned
- Jun 17, 2008
- Last updated
- Jun 24, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lynden Kurtz
- Title
- Owner/President
- Phone
- (701) 451-9417
Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | Primary |
Addresses
Primary practice location
4420 37TH Ave S
Fargo, ND 58104-3400
Mailing address
1711 Gold Dr S
Suite 120
Fargo, ND 58103-6416
Phone (701) 451-9417
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in ND
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20041006001028 | ND | Part B Supplier - Clinic/Group Practice | 5193784080 |
Receives reassigned benefits from 13 practitioners 3 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Fargo, ND |
Other NPIs on the same Medicare enrollment 3
NPIs listed together on one Medicare enrollment, typically parts of the same organization.
-
dba Prorehab Center
- Physical Therapist
- Fargo, ND
- NPI 1326460528
O20041006001028
-
dba Pro Rehab Center, Inc
- Physical Therapist
- Fargo, ND
- NPI 1164753737
O20041006001028
-
dba Pro Rehab Center, Inc
- Physical Therapist
- Fargo, ND
- NPI 1215014105
O20041006001028
National Provider Directory
National Provider DirectoryPractitioners & affiliated clinicians
Practitioners 1
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.
-
- Physical Medicine & Rehabilitation Physician
- Fargo, ND
- NPI 1548240104
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1213660800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1214265600000",
"number": "1003076613",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1711 GOLD DR S",
"address_2": "SUITE 120",
"city": "FARGO",
"state": "ND",
"postal_code": "581036416",
"telephone_number": "701-451-9417"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4420 37TH AVE S",
"city": "FARGO",
"state": "ND",
"postal_code": "581043400",
"telephone_number": "701-451-9417"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "PROFESSIONAL REHABILITATION CENTER INC",
"organizational_subpart": "NO",
"enumeration_date": "2008-06-17",
"last_updated": "2008-06-24",
"status": "A",
"authorized_official_last_name": "KURTZ",
"authorized_official_first_name": "LYNDEN",
"authorized_official_title_or_position": "OWNER/PRESIDENT",
"authorized_official_telephone_number": "701-451-9417"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Physical Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Fargo, ND
- Professional Association of Treatment Homes
- Professional Optical
- Professional Optical
- Professional Rehabilitation Center (Prorehab Center)
- Professional Rehabilitation Center (ProRehab Center)
- Professional Rehabilitation Center Inc (Pro Rehab Center, Inc)
- Professional Rehabilitation Center Inc (Pro Rehab Center, Inc)
- Progress Weight Management PLLC
- Progressive Therapy Associates
- Eric R Promersberger, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.