Physical Medicine, P.C.

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

042374 Issued in MI

Legal business name

PHYSICAL MEDICINE, P.C.

Practice address

20307 W 12 Mile Rd
Ste. 102
Southfield, MI 48076-5407

Phone

(248) 356-6661

Fax

(248) 356-6619

NPI assigned

Jan 17, 2008

Organization subpart

No

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

Authorized official

Name

Dr. Jack G. Belen, M.D.

Title

President

Phone

(248) 365-6661

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Jack Belen, M.D. Doing business as

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

{
    "created_epoch": "1200528000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1200528000000",
    "number": "1043496250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20307 W. 12 MILE",
            "address_2": "STE. 102",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "48076",
            "telephone_number": "248-356-6661",
            "fax_number": "248-356-6619"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20307 W 12 MILE RD",
            "address_2": "STE. 102",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480765407",
            "telephone_number": "248-356-6661",
            "fax_number": "248-356-6619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHYSICAL MEDICINE, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-17",
        "last_updated": "2008-01-17",
        "status": "A",
        "authorized_official_last_name": "BELEN",
        "authorized_official_first_name": "JACK",
        "authorized_official_middle_name": "G.",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "248-365-6661",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "042374",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1552582",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Jack Belen, M.D.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Phoenix Empowerment Services LLC
• Phoenix Medical Group, P.C.
• Phoenix Rizing Inc.
• Physical Medicine and Wellness PC
• Physical Medicine Consultants PC
• Physical Therapy and Fitness LLC
• Physical Therapy Services, Inc.
• Physical Therapy Services, Inc.
• Physical Therapy Solutions Service
• Physical Therapy Southfield, P.C.

• Physical Medicine & Rehabilitation Physician in Southfield, MI
• Providers in Southfield, MI by specialty
• Physical Medicine & Rehabilitation Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 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.