Advanced Rehabilitation, LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

License

888 Issued in NC

Legal business name

ADVANCED REHABILITATION, LLC

Practice address

1437 E Franklin Blvd Ste 128
Gastonia, NC 28054-4059

Phone

(704) 865-6126

Fax

(704) 865-4837

NPI assigned

Jul 22, 2008

Organization subpart

No

Name

Anisa Chun Kong, OTR/L, CHT

Title

Director

Phone

(704) 865-6126

Locations

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 22, 2008.

{
    "created_epoch": "1216684800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216684800000",
    "number": "1043475718",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1437 E FRANKLIN BLVD STE 128",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280544059",
            "telephone_number": "704-865-6126",
            "fax_number": "704-865-4837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1437 E FRANKLIN BLVD STE 128",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280544059",
            "telephone_number": "704-865-6126",
            "fax_number": "704-865-4837"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-07-22",
        "last_updated": "2008-07-22",
        "status": "A",
        "authorized_official_last_name": "KONG",
        "authorized_official_first_name": "ANISA",
        "authorized_official_middle_name": "CHUN",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "704-865-6126",
        "authorized_official_credential": "OTR/L, CHT"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NC",
            "license": "888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Rehabilitation Clinic/Center in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 2008; 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.