Industricare Physical Rehabilitation PC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC029478 Issued in PA

Legal business name

INDUSTRICARE PHYSICAL REHABILITATION PC

Practice address

1900 S Broad St
Philadelphia, PA 19145-2304

Phone

(215) 339-4260

Fax

(215) 339-4276

NPI assigned

May 20, 2009

Last updated

May 20, 2009By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. James Francis Bonner, MDNPI 1184642407

Title

Owner

Phone

(610) 490-3900

Specialties & licenses 2

Addresses

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.

• James Francis Bonner, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Wilmington, DE
  • NPI 1184642407
  Authorized official Same address or phone

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

{
    "created_epoch": "1242777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242777600000",
    "number": "1023243086",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1900 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191452304",
            "telephone_number": "215-339-4260",
            "fax_number": "215-339-4276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1900 S BROAD ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191452304",
            "telephone_number": "215-339-4260",
            "fax_number": "215-339-4276"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDUSTRICARE PHYSICAL REHABILITATION PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-20",
        "last_updated": "2009-05-20",
        "status": "A",
        "authorized_official_last_name": "BONNER",
        "authorized_official_first_name": "JAMES",
        "authorized_official_middle_name": "FRANCIS",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "610-490-3900",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "PA",
            "license": "DC029478",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD034149L",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Chiropractor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.