Renaissance Rehabilitation Professionals LLC

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

5201006389 Issued in MI

Legal business name

RENAISSANCE REHABILITATION PROFESSIONALS LLC

Practice address

3103 Meadowcroft LN
Kalamazoo, MI 49004-3773

Phone

(269) 568-5683

Fax

(866) 303-9355

NPI assigned

Jun 23, 2009

Last updated

Jun 23, 2009By 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

Christian M Petrovich, OTRNPI 1134339021

Title

Sole MBR

Phone

(269) 568-5683

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.

• Christian Michael Petrovich, OTR

  • Occupational Therapist
  • Kalamazoo, MI
  • NPI 1134339021
  NPD (past) Authorized official

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

{
    "created_epoch": "1245715200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1245715200000",
    "number": "1093943664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3103 MEADOWCROFT LN",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490043773",
            "telephone_number": "269-568-5683",
            "fax_number": "866-303-9355"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3103 MEADOWCROFT LN",
            "city": "KALAMAZOO",
            "state": "MI",
            "postal_code": "490043773",
            "telephone_number": "269-568-5683",
            "fax_number": "866-303-9355"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RENAISSANCE REHABILITATION PROFESSIONALS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-06-23",
        "last_updated": "2009-06-23",
        "status": "A",
        "authorized_official_last_name": "PETROVICH",
        "authorized_official_first_name": "CHRISTIAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "SOLE MBR",
        "authorized_official_telephone_number": "269-568-5683",
        "authorized_official_credential": "OTR"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "MI",
            "license": "5201006389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kristen Reister
• Gerard Remillard III
• Mark Joseph Remmler, PA-C
• Renaissance Rehabilitation Associates
• Renaissance Rehabilitation Associates PLLC
• Renal Care Group Southwest Michigan, LLC (Fresenius Medical Care Kalamazoo Home)
• Renal Care Group Southwest Michigan, LLC (Fresenius Medical Care - Kalamazoo East)
• Renal Care Group Southwest Michigan, LLC (RCG Kalamazoo)
• Renal Care Group Southwest Michigan, LLC (RCG Oshtemo)
• Renal Care Pharmacy (Will Plemmons)

• Occupational Therapist in Kalamazoo, MI
• Providers in Kalamazoo, MI by specialty
• Occupational Therapist in Michigan

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