Northshore Rehab PLLC

Primary specialty

Pain Medicine (Physical Medicine & Rehabilitation) PhysicianTaxonomy code 2081P2900X

License

5101013561 Issued in MI

Legal business name

NORTHSHORE REHAB PLLC

Practice address

901 W Front St
Suite B
Traverse City, MI 49684-2374

Phone

(231) 947-5071

Fax

(231) 947-5094

NPI assigned

Oct 20, 2006

Organization subpart

No

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

Authorized official

Name

Karen Lynn Meyer, DO

Title

President S Corporation

Phone

(231) 947-5071

Specialties & licenses 1

Addresses

Other identifiers 2

Locations

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1266451200000",
    "number": "1306928841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 W FRONT ST",
            "address_2": "SUITE B",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842374",
            "telephone_number": "231-947-5071",
            "fax_number": "231-947-5094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 W FRONT ST",
            "address_2": "SUITE B",
            "city": "TRAVERSE CITY",
            "state": "MI",
            "postal_code": "496842374",
            "telephone_number": "231-947-5071",
            "fax_number": "231-947-5094"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NORTHSHORE REHAB PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-20",
        "last_updated": "2010-02-18",
        "status": "A",
        "authorized_official_last_name": "MEYER",
        "authorized_official_first_name": "KAREN",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT S CORPORATION",
        "authorized_official_telephone_number": "231-947-5071",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "2081P2900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation, Pain Medicine",
            "state": "MI",
            "license": "5101013561",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PIN #",
            "identifier": "2552810134",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4673607",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Northern Woods Counseling & Consulting Services, Inc.
• Northway and Hall Orthodontics PLLC
• William M Northway, D.D.S.,M.S.
• Northwest Michigan Community Action Agency
• Northwest Michigan Health Services Inc.
• Northwest Michigan Health Services, Inc

• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Traverse City, MI
• Providers in Traverse City, MI by specialty
• Pain Medicine (Physical Medicine & Rehabilitation) Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2010; 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.