NPIMap

Organization Active NPI

Novacare Outpatient Rehabilitation East Inc

Doing business as NovaCare Rehabilitation

  • Durable Medical Equipment & Medical Supplies
  • Woodbury, MN
National Provider Identifier
1053529016
Registry record updated Mar 14, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Durable Medical Equipment & Medical SuppliesTaxonomy code 332B00000X
Legal business name
NOVACARE OUTPATIENT REHABILITATION EAST INC
Doing business as
NovaCare Rehabilitation
Practice address
1687 Woodlane Dr
Number 104
Woodbury, MN 55125-3045
Phone
(651) 702-0555
Fax
(651) 702-5680
NPI assigned
May 21, 2007
Last updated
Mar 14, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2008

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

Authorized official

Name
Michael Tarvin
Title
Vice President
Phone
(717) 975-4503

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Durable Medical Equipment & Medical Supplies 332B00000X NU Primary

Addresses

Primary practice location

1687 Woodlane Dr
Number 104
Woodbury, MN 55125-3045

Mailing address

4716 Gettysburg Rd
Legal Department
Mechanicsburg, PA 17055-4325
Phone (717) 975-4503

Other names 1

  • NovaCare Rehabilitation Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Novacare Outpatient Rehab50 organizations share this tax ID, including this one

Other organizations with this tax ID 49

Organizations that report the same tax identification number in the National Provider Directory.

View all 49

Locations

1687 Woodlane Dr
Ste 104
Woodbury, MN 55125
Phone (651) 702-0555

4716 Gettysburg Rd
Mechanicsburg, PA 17055

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1205452800000",
    "number": "1053529016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4716 GETTYSBURG RD",
            "address_2": "LEGAL DEPARTMENT",
            "city": "MECHANICSBURG",
            "state": "PA",
            "postal_code": "170554325",
            "telephone_number": "717-975-4503",
            "fax_number": "717-975-9981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1687 WOODLANE DR",
            "address_2": "NUMBER 104",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "551253045",
            "telephone_number": "651-702-0555",
            "fax_number": "651-702-5680"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NOVACARE OUTPATIENT REHABILITATION EAST INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-05-21",
        "last_updated": "2008-03-14",
        "status": "A",
        "authorized_official_last_name": "TARVIN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "VICE PRESIDENT",
        "authorized_official_telephone_number": "717-975-4503"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "NovaCare Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Woodbury, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 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.