Professional Rehabilitation Center Inc

Primary specialty

Physical TherapistTaxonomy code 225100000X

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

Organization subpart

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in ND

Enrollment records 1

Other NPIs on the same Medicare enrollment 3

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

• Professional Rehabilitation Center

  • Physical Therapist
  • Fargo, ND
  • NPI 1326460528

  O20041006001028

  Same enrollment
• Professional Rehabilitation Center Inc

  • Physical Therapist
  • Fargo, ND
  • NPI 1164753737

  O20041006001028

  Same enrollment
• Professional Rehabilitation Center Inc

  • Physical Therapist
  • Fargo, ND
  • NPI 1215014105

  O20041006001028

  Same enrollment

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": []
}

• Professional Association of Treatment Homes
• Professional Optical
• Professional Optical
• Professional Rehabilitation Center
• Professional Rehabilitation Center
• Professional Rehabilitation Center Inc
• Professional Rehabilitation Center Inc
• Progress Weight Management PLLC
• Progressive Therapy Associates
• Eric R Promersberger, MD

• Physical Therapist in Fargo, ND
• Providers in Fargo, ND by specialty
• Physical Therapist in North Dakota

• 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.

Verify at the official NPI Registry.