Organization Active NPI

Great East Rehabilitation, LLC

  • Orthopedic Physical Therapist
  • Warren, OH
National Provider Identifier
1154629004
Registry record updated Mar 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Orthopedic Physical TherapistTaxonomy code 2251X0800X
License
PT006881 Issued in OH
Legal business name
GREAT EAST REHABILITATION, LLC
Practice address
953 Niles Cortland Rd SE
Warren, OH 44484-2538
Phone
(330) 652-2287
Fax
(330) 544-3904
NPI assigned
Mar 2, 2011
Organization subpart
Yes
Parent organization
2103 NILES CORTLAND ROAD SE WARREN, OH 44484-3067As reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 4, 2011

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

Authorized official

Name
Mrs. Angela Mulichak
Title
Billing Coordinator
Phone
(330) 652-2287

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Orthopedic Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 2251X0800X PT006881 OH Primary

Addresses

Primary practice location

953 Niles Cortland Rd SE
Warren, OH 44484-2538

Mailing address

2103 Niles Cortland Rd SE
Warren, OH 44484-3067
Phone (330) 652-2287

National Provider Directory

National Provider Directory
Part of
Great East Rehabilitation LLC

NPI Registry JSON

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

{
    "created_epoch": "1299024000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1299196800000",
    "number": "1154629004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2103 NILES CORTLAND RD SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444843067",
            "telephone_number": "330-652-2287",
            "fax_number": "330-544-3904"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "953 NILES CORTLAND RD SE",
            "city": "WARREN",
            "state": "OH",
            "postal_code": "444842538",
            "telephone_number": "330-652-2287",
            "fax_number": "330-544-3904"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT EAST REHABILITATION, LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "2103 NILES CORTLAND ROAD SE  WARREN, OH  44484-3067",
        "enumeration_date": "2011-03-02",
        "last_updated": "2011-03-04",
        "status": "A",
        "authorized_official_last_name": "MULICHAK",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_title_or_position": "BILLING COORDINATOR",
        "authorized_official_telephone_number": "330-652-2287",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist, Orthopedic",
            "state": "OH",
            "license": "PT006881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2011; 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.