NPIMap

Organization Active NPI

Relive Rehab Group

  • Clinical Social Worker
  • Wichita, KS
National Provider Identifier
1104170059
Registry record updated Oct 30, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
8422 Issued in KS
Legal business name
RELIVE REHAB GROUP
Practice address
2020 N Tyler Rd Ste 112
Wichita, KS 67212-4916
Phone
(316) 295-4591
Fax
(316) 295-4713
NPI assigned
Oct 30, 2012
Last updated
Oct 30, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2012

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

Authorized official

Name
Perry YoungNPI 1467825729
Title
Divisional Vice President
Phone
(316) 295-4591

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 8422 KS Primary

Addresses

Primary practice location

2020 N Tyler Rd Ste 112
Wichita, KS 67212-4916

Mailing address

2020 N Tyler Rd Ste 112
Wichita, KS 67212-4916
Phone (316) 295-4591

National Provider Directory

National Provider Directory
Tax ID family
Key Rehabilitation Oak Tree7 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.

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1351555200000",
    "number": "1104170059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2020 N TYLER RD STE 112",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672124916",
            "telephone_number": "316-295-4591",
            "fax_number": "316-295-4713"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2020 N TYLER RD STE 112",
            "city": "WICHITA",
            "state": "KS",
            "postal_code": "672124916",
            "telephone_number": "316-295-4591",
            "fax_number": "316-295-4713"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RELIVE REHAB GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-10-30",
        "last_updated": "2012-10-30",
        "status": "A",
        "authorized_official_last_name": "YOUNG",
        "authorized_official_first_name": "PERRY",
        "authorized_official_title_or_position": "DIVISIONAL VICE PRESIDENT",
        "authorized_official_telephone_number": "316-295-4591"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "KS",
            "license": "8422",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wichita, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2012; 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.