Injury Rehab Center LLC

Primary specialty

ChiropractorTaxonomy code 111N00000X

Legal business name

INJURY REHAB CENTER LLC

Doing business as

Advanced Injury Rehab

Practice address

102 Manor Ave Ste 202
Bardstown, KY 40004-2553

Phone

(502) 233-3456

NPI assigned

May 21, 2019

Last updated

Nov 28, 2022By 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

Dawn Wietfeldt, DC

Title

Member

Phone

(502) 233-3456

Specialties & licenses 3

Addresses

Other names 1

• Advanced Injury Rehab Doing business as

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.

• Fumiyo Ueda, MAT

  • Massage Therapist
  • Honolulu, HI
  • NPI 1902282452
  NPD

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

{
    "created_epoch": "1558396800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1669593600000",
    "number": "1114584612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 MANOR AVE STE 202",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400042553",
            "telephone_number": "502-233-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 MANOR AVE STE 202",
            "city": "BARDSTOWN",
            "state": "KY",
            "postal_code": "400042553",
            "telephone_number": "502-233-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INJURY REHAB CENTER LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-05-21",
        "last_updated": "2022-11-28",
        "certification_date": "2022-11-28",
        "status": "A",
        "authorized_official_last_name": "WIETFELDT",
        "authorized_official_first_name": "DAWN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "502-233-3456",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Advanced Injury Rehab",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Chiropractor in Bardstown, KY
• Providers in Bardstown, KY by specialty
• Chiropractor in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2022; 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.