Powerback Rehabilitation LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

POWERBACK REHABILITATION LLC

Practice address

2300 Clemson Rd
Columbia, SC 29229-6872

Phone

(803) 400-8881

NPI assigned

Mar 6, 2015

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Carl Anthony Shrom

Title

Ceo

Phone

(215) 896-0422

Specialties & licenses 1

Addresses

Other names 1

• POWERBACK REHABILITATION Doing business as

Medicare fee-for-service enrollment

Enrolled in SC

Enrollment records 1

Tax ID family

Genesis Rehab Serv209 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 5

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Genesis Eldercare Rehabilitation Services LLC

  • Rehabilitation Clinic/Center
  • Port Royal, SC
  • NPI 1194234773
  NPD tax ID
• Genesis Rehab

  • Case Management Agency
  • Columbia, SC
  • NPI 1225341589
  NPD tax ID
• Genesis Rehab Services

  • Rehabilitation Clinic/Center
  • Pawleys Island, SC
  • NPI 1265841001
  NPD tax ID
• Powerback Rehabilitation LLC

  • Physical Therapist
  • Charleston, SC
  • NPI 1659257806
  NPD tax ID
• Powerback Rehabilitation LLC

  • Rehabilitation Clinic/Center
  • Simpsonville, SC
  • NPI 1689066615
  NPD tax ID

All facility ownership & control disclosures 25

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1425600000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1673308800000",
    "number": "1013300698",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "address_2": "C/O AMY NUNEMAKER",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109",
            "telephone_number": "610-925-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2300 CLEMSON RD",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292296872",
            "telephone_number": "803-400-8881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWERBACK REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-03-06",
        "last_updated": "2023-01-10",
        "certification_date": "2023-01-10",
        "status": "A",
        "authorized_official_last_name": "SHROM",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-896-0422"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "POWERBACK REHABILITATION",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Marie Mahoney Powell, MSP, CCC-SLP
• Maxine Angella Powell, RN
• O Henderson Powell, MD
• Stephen Powell Sr.
• Thomas Brian Powell, M.D.
• Bradley Powers, O.D.
• Casey Patrick Powers, PT
• Emily Lauren Powers
• Emma Powers
• Heather Merrill Powers, MD

• Rehabilitation Clinic/Center in Columbia, SC
• Providers in Columbia, SC by specialty
• Rehabilitation Clinic/Center in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.