Peninsula Pain and Rehabilitation Center, Inc.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

0104001063 Issued in VA

Legal business name

PENINSULA PAIN AND REHABILITATION CENTER, INC.

Practice address

11015 Warwick Blvd
Newport News, VA 23601-3225

Phone

(757) 591-7291

Fax

(757) 591-2125

NPI assigned

Aug 22, 2006

Last updated

Jul 2, 2024By 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

Michael S Cook, DCNPI 1578585790

Title

Owner

Phone

(757) 591-7291

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in VA

Enrollment records 1

Locations

Practitioners 2

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.

• Michael S Cook, DC

  • Chiropractor
  • Newport News, VA
  • NPI 1578585790
  Medicare reassignment Authorized official
• Catherine Carol Rivera, PT

  • Physical Therapist
  • Denham Springs, LA
  • NPI 1891068870
  NPD (past)

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

{
    "created_epoch": "1156204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1719878400000",
    "number": "1053427740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11015 WARWICK BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236013225",
            "telephone_number": "757-591-7291",
            "fax_number": "757-591-2125"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11015 WARWICK BLVD",
            "city": "NEWPORT NEWS",
            "state": "VA",
            "postal_code": "236013225",
            "telephone_number": "757-591-7291",
            "fax_number": "757-591-2125"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PENINSULA PAIN AND REHABILITATION CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-22",
        "last_updated": "2024-07-02",
        "certification_date": "2024-07-02",
        "status": "A",
        "authorized_official_last_name": "COOK",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "757-591-7291",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "VA",
            "license": "0104001063",
            "primary": true
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "VA",
            "license": "VA0101022154",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peninsula Institute for Community Health Inc (48th Street Physicians)
• Peninsula Institute for Community Health Inc (Warwick Boulevard Physicians)
• Peninsula Institute for Community Health Inc (East End Physicians)
• Peninsula Neurology LTD
• Peninsula Orthodontics, PC
• Peninsula Pastoral Counseling Center Inc. (Peninsula Pastoral Counseling Center)
• Peninsula Pathology Associates Incorporated
• Peninsula Pathology Associates of Virginia PLLC
• Peninsula Pediatric Dentistry, P.C.
• Peninsula Pediatric Psychiatry

• Chiropractor in Newport News, VA
• Providers in Newport News, VA by specialty
• Chiropractor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2024; 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.