Central Indiana Physical Medicine & Rehab

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

CENTRAL INDIANA PHYSICAL MEDICINE & REHAB

Practice address

1107 S Tillotson Ave
Ste 1
Muncie, IN 47304-4517

Phone

(765) 213-3024

Fax

(765) 282-9303

NPI assigned

Jul 31, 2006

Last updated

Jan 16, 2020By 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. Miriam Ibrahim, MDNPI 1194768549

Title

President

Phone

(765) 213-3024

Specialties & licenses 1

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.

• Miriam Lela Ibrahim, MD

  • Physical Medicine & Rehabilitation Physician
  • Muncie, IN
  • NPI 1194768549
  NPD (past) Authorized official

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579132800000",
    "number": "1063428217",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2001 N GRANVILLE AVE",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473032110",
            "telephone_number": "765-213-3238",
            "fax_number": "765-284-2434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 S TILLOTSON AVE",
            "address_2": "STE 1",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473044517",
            "telephone_number": "765-213-3024",
            "fax_number": "765-282-9303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTRAL INDIANA PHYSICAL MEDICINE & REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-31",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A",
        "authorized_official_last_name": "IBRAHIM",
        "authorized_official_first_name": "MIRIAM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "765-213-3024",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Central Indiana OB/GYN, LLC
• Central Indiana Orthopedic Surgery Center, LLC (OrthoAlliance of Indiana)
• Central Indiana Orthopedic Surgery Center, LLC
• Central Indiana Orthopedics LLC (OrthoAlliance of Indiana)
• Central Indiana Orthopedics, LLC
• Central Indiana-Amg Specialty Hospital, LLC
• Central Indiana-Amg Specialty Hospital, LLC
• Jonathan Chae, M.D.
• Daniel Chalfant, OPTICIAN
• Tyson Chalfant, RBT

• Physical Medicine & Rehabilitation Physician in Muncie, IN
• Providers in Muncie, IN by specialty
• Physical Medicine & Rehabilitation Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; 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.