NPIMap

Organization Active NPI

Mary Free Bed Rehabilitation Hosptial

  • Rehabilitation Hospital
  • Grand Rapids, MI
National Provider Identifier
1063740561
Registry record updated Nov 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation HospitalTaxonomy code 283X00000X
License
L1386838 Issued in MI
Legal business name
MARY FREE BED REHABILITATION HOSPTIAL
Practice address
235 Wealthy St SE
Grand Rapids, MI 49503-5247
Phone
(616) 242-0300
Fax
(616) 242-0438
NPI assigned
Nov 23, 2009
Last updated
Nov 23, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 23, 2009

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

Authorized official

Name
Randall L Deneff
Title
Cfo
Phone
(616) 242-0403

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital 283X00000X L1386838 MI Primary

Addresses

Primary practice location

235 Wealthy St SE
Grand Rapids, MI 49503-5247

Mailing address

235 Wealthy St SE
Grand Rapids, MI 49503-5247
Phone (616) 242-0300

Other identifiers 1

IdentifierTypeStateIssuer
3996OtherPRIORITY HEALTH RADIOLOGY

National Provider Directory

National Provider Directory
Tax ID family
Mary Free Bed Hospital and Rehabilitation7 organizations share this tax ID, including this one

Other organizations with this tax ID 6

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

NPI Registry JSON

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

{
    "created_epoch": "1258934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258934400000",
    "number": "1063740561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "235 WEALTHY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035247",
            "telephone_number": "616-242-0300",
            "fax_number": "616-242-0438"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "235 WEALTHY ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495035247",
            "telephone_number": "616-242-0300",
            "fax_number": "616-242-0438"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARY FREE BED REHABILITATION HOSPTIAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-11-23",
        "last_updated": "2009-11-23",
        "status": "A",
        "authorized_official_last_name": "DENEFF",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "616-242-0403"
    },
    "taxonomies": [
        {
            "code": "283X00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Hospital",
            "state": "MI",
            "license": "L1386838",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIORITY HEALTH RADIOLOGY",
            "identifier": "3996",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2009; 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.