Greater Metro Rehab LLC

Primary specialty

Orthopedic Physical TherapistTaxonomy code 2251X0800X

License

A106496 Issued in MI

Legal business name

GREATER METRO REHAB LLC

Practice address

20240 W 12 Mile Rd
Southfield, MI 48076-2426

Phone

(248) 353-6880

Fax

(734) 692-6195

NPI assigned

Nov 19, 2010

Organization subpart

No

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

Authorized official

Name

Ms. Marcia Fosnaugh Avis, R.N.

Title

Clinic Director

Phone

(248) 353-6880

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1290124800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1290124800000",
    "number": "1073815361",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 WOODBERRY DR",
            "city": "BLOOMFIELD HILLS",
            "state": "MI",
            "postal_code": "483043561",
            "telephone_number": "248-353-6880",
            "fax_number": "734-692-6195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20240 W 12 MILE RD",
            "city": "SOUTHFIELD",
            "state": "MI",
            "postal_code": "480762426",
            "telephone_number": "248-353-6880",
            "fax_number": "734-692-6195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREATER METRO REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-11-19",
        "last_updated": "2010-11-19",
        "status": "A",
        "authorized_official_last_name": "AVIS",
        "authorized_official_first_name": "MARCIA",
        "authorized_official_middle_name": "FOSNAUGH",
        "authorized_official_title_or_position": "CLINIC DIRECTOR",
        "authorized_official_telephone_number": "248-353-6880",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "R.N."
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "MI",
            "license": "A106496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Orthopedic Physical Therapist in Southfield, MI
• Providers in Southfield, MI by specialty
• Orthopedic Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2010; 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.