Centers for Rehabilitation, Pain MGMT, & Wellness

Primary specialty

SpecialistTaxonomy code 174400000X

License

D47483 Issued in MD

Legal business name

CENTERS FOR REHABILITATION, PAIN MGMT, & WELLNESS

Practice address

2600 Liberty Heights Ave.
3Rd Floor
Baltimore, MD 21215-7804

Phone

(410) 383-4263

Fax

(410) 383-4005

NPI assigned

May 5, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Heather A Jaconski

Title

Billing Representative

Phone

(301) 953-1266

Specialties & licenses 1

Addresses

Other identifiers 1

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kisha Perkins Brown, MD

  • Physical Medicine & Rehabilitation Physician
  • Upper Marlboro, MD
  • NPI 1053456566

  Physical Medicine & Rehabilitation

  NPD (past)
• Cornell Shelton, MD

  • Physical Medicine & Rehabilitation Physician
  • Fredericksburg, VA
  • NPI 1003807538

  Physical Medicine & Rehabilitation

  NPD (past)

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

{
    "created_epoch": "1146787200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1242864000000",
    "number": "1083662753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2600 LIBERTY HEIGHTS AVE.",
            "address_2": "3RD FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212157804",
            "telephone_number": "410-383-4263",
            "fax_number": "410-383-4005"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2600 LIBERTY HEIGHTS AVE.",
            "address_2": "3RD FLOOR",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212157804",
            "telephone_number": "410-383-4263",
            "fax_number": "410-383-4005"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CENTERS FOR REHABILITATION, PAIN MGMT, & WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-05",
        "last_updated": "2009-05-21",
        "status": "A",
        "authorized_official_last_name": "JACONSKI",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "BILLING REPRESENTATIVE",
        "authorized_official_telephone_number": "301-953-1266",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "MD",
            "license": "D47483",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DO4133",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• All providers in Baltimore, MD
• Specialist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 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.