Active NPI
Quality Recreation & Rehabilitation
- Internal Medicine Physician
- Detroit, MI
National Provider Identifier
1144351404
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- AH051664
- Legal business name
- QUALITY RECREATION & REHABILITATION
- Practice address
- 2641 W. Grand Blvd.
Detroit, MI 48202 - Phone
- (313) 874-3129
- Fax
- (248) 354-3901
- NPI assigned
- Mar 8, 2007
- Last updated
- May 26, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Beth R Jenkins
- Title
- Program Director
- Phone
- (313) 874-3129
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | AH051664 | MI | Primary |
Addresses
Primary practice location
2641 W. Grand Blvd.
Detroit, MI 48202
Mailing address
2641 W Grand Blvd
Detroit, MI 48208-1234
Phone (313) 874-3129
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104662210 | Medicaid | MI | |
| 110H222590 | Other | MI | BLUE CROSS BLUE SHIELD |
National Provider Directory
National Provider DirectoryLocations
801 Virginia Park St
Detroit, MI 48202
Phone (248) 539-4640
Practitioners & affiliated clinicians
Practitioners 3
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.
-
- Psychiatry Physician
- Bloomfield Hills, MI
- NPI 1992742597
-
- Internal Medicine Physician
- Farmington Hills, MI
- NPI 1770553521
-
- General Practice Physician
- Southfield, MI
- NPI 1295782951
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1211760000000",
"number": "1144351404",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2641 W GRAND BLVD",
"city": "DETROIT",
"state": "MI",
"postal_code": "482081234",
"telephone_number": "313-874-3129",
"fax_number": "248-354-3901"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2641 W. GRAND BLVD.",
"city": "DETROIT",
"state": "MI",
"postal_code": "48202",
"telephone_number": "313-874-3129",
"fax_number": "248-354-3901"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "QUALITY RECREATION & REHABILITATION",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-08",
"last_updated": "2008-05-26",
"status": "A",
"authorized_official_last_name": "JENKINS",
"authorized_official_first_name": "BETH",
"authorized_official_middle_name": "R",
"authorized_official_title_or_position": "PROGRAM DIRECTOR",
"authorized_official_telephone_number": "313-874-3129",
"authorized_official_name_prefix": "Mrs."
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "MI",
"license": "AH051664",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104662210",
"state": "MI"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "110H222590",
"state": "MI"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Detroit, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.