Powerback Rehabilitation LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

POWERBACK REHABILITATION LLC

Doing business as

Powerback Rehabilitation

Practice address

104 Fakes CT
C/O Landmark at Charleston House
Beaver Dam, WI 53916-2699

Phone

(610) 925-4560

NPI assigned

May 20, 2016

Organization subpart

No

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

Authorized official

Name

Carl Anthony Shrom

Title

Ceo

Phone

(215) 896-0422

Specialties & licenses 1

Addresses

Other names 1

• Powerback Rehabilitation Doing business as

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

{
    "created_epoch": "1463702400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678060800000",
    "number": "1265889158",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "address_2": "C/O AMY NUNEMAKER",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109",
            "telephone_number": "610-925-4560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 FAKES CT",
            "address_2": "C/O LANDMARK AT CHARLESTON HOUSE",
            "city": "BEAVER DAM",
            "state": "WI",
            "postal_code": "539162699",
            "telephone_number": "610-925-4560"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWERBACK REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-05-20",
        "last_updated": "2023-03-06",
        "certification_date": "2023-03-06",
        "status": "A",
        "authorized_official_last_name": "SHROM",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "215-896-0422"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Powerback Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Dena L Piechowski, NP
• Mary Jo Pleuss, CSW, ICS, CSAC
• Phyllis Ann Pleuss, LCSW
• David Evan Poehr
• Dawn Debra Poull, FNP-BC
• Prairie Ridge Health, Inc.
• Prime Nemt Transportation LLC
• Kenneth Lamar Prust, LCSW
• Kaitlyn N Pufahl, CPNP
• Cameron Christopher Pumilia

• Rehabilitation Clinic/Center in Beaver Dam, WI
• Providers in Beaver Dam, WI by specialty
• Rehabilitation Clinic/Center in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 6, 2023; 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.