Independence Rehabilitation LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

MD431974 Issued in PA

Legal business name

INDEPENDENCE REHABILITATION LLC

Practice address

1237 W Sherman Ave
Vineland, NJ 08360-6920

Phone

(717) 875-8909

Fax

(818) 671-2225

NPI assigned

Oct 14, 2014

Organization subpart

No

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

Authorized official

Name

Fan XI, M.D.NPI 1881619005

Title

Owner

Phone

(717) 875-8909

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NJ

Enrollment records 1

Practitioners 1

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

• Fan XI, MD

  • Pain Medicine (Physical Medicine & Rehabilitation) Physician
  • Wilmington, NC
  • NPI 1881619005

  NJ

  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1413244800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1413244800000",
    "number": "1144624560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1425 PICKET DR",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176014583",
            "telephone_number": "717-875-8909",
            "fax_number": "818-671-2225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1237 W SHERMAN AVE",
            "city": "VINELAND",
            "state": "NJ",
            "postal_code": "083606920",
            "telephone_number": "717-875-8909",
            "fax_number": "818-671-2225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-10-14",
        "last_updated": "2014-10-14",
        "status": "A",
        "authorized_official_last_name": "XI",
        "authorized_official_first_name": "FAN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "717-875-8909",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "MD431974",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mustafa Sarmad Ibrahim, DPM
• Ed Igle, MSW
• Ngozi Udoka Iloka, PT.DPT.MPH
• Nnamdi Ilonzo, DO
• Imaging Associates, PA (South Jersey MRI)
• Andrew Joseph Ines, MD
• Leonard Vincent Infranco, D.M.D.
• Infusion Services of South Jersey LLC
• Innovative ABA
• Inspira Health Network

• Physical Medicine & Rehabilitation Physician in Vineland, NJ
• Providers in Vineland, NJ by specialty
• Physical Medicine & Rehabilitation Physician in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.