Northern Edge Institute of Rehabilitation

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

Legal business name

NORTHERN EDGE INSTITUTE OF REHABILITATION

Practice address

267 Creekside Dr Ste 200
Petoskey, MI 49770-7609

Phone

(231) 348-1995

NPI assigned

Aug 9, 2006

Last updated

Mar 25, 2008By 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

Keith Rose, M.D.NPI 1063422285

Title

President

Phone

(231) 348-1995

Specialties & licenses 1

Addresses

Locations

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.

• Keith Rose, M.D.

  • Physical Medicine & Rehabilitation Physician
  • Petoskey, MI
  • NPI 1063422285
  NPD (past) Authorized official

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1206403200000",
    "number": "1295745412",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1024",
            "city": "CADILLAC",
            "state": "MI",
            "postal_code": "496016024",
            "telephone_number": "231-775-6076",
            "fax_number": "231-775-0027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "267 CREEKSIDE DR STE 200",
            "city": "PETOSKEY",
            "state": "MI",
            "postal_code": "497707609",
            "telephone_number": "231-348-1995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHERN EDGE INSTITUTE OF REHABILITATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-09",
        "last_updated": "2008-03-25",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "KEITH",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "231-348-1995",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Petoskey, MI
• Providers in Petoskey, MI by specialty
• Physical Medicine & Rehabilitation Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 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.

Verify at the official NPI Registry.