NPIMap

Organization Active NPI

Iron Range Rehabilitation Center

  • Rehabilitation Clinic/Center
  • Virginia, MN
National Provider Identifier
1316098445
Registry record updated Oct 23, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
IRON RANGE REHABILITATION CENTER
Practice address
901 9TH St N
Suite 100
Virginia, MN 55792-2279
Phone
(218) 749-9405
Fax
(218) 749-9407
NPI assigned
Jan 16, 2007
Last updated
Oct 23, 2014By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2014

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

Authorized official

Name
Mr. Andrew ElliottNPI 1639341464
Title
Executive Director
Phone
(218) 749-9405

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

901 9TH St N
Suite 100
Virginia, MN 55792-2279

Mailing address

901 9TH St N
Suite 100
Virginia, MN 55792-2279
Phone (218) 749-9405

Other identifiers 1

IdentifierTypeStateIssuer
575555700MedicaidMN

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1316098445. Details of each certification follow.

  • CCN 246503 Outpatient physical therapy / speech pathology · Active · Name & address match · Details

Outpatient physical therapy / speech pathology certification: CCN 246503

Name & address match This certification has no NPI in the Medicare enrollment files. CMS publishes enrollment files for six facility types only, so it was connected to this NPI by matching the name and address CMS publishes for it.

Legal name
IRON RANGE REHAB CENTER
Certification status
Active
Provider type (POS)
Outpatient physical therapy / speech pathology
Participating since
Jul 1, 1968
Last certification
Apr 2, 2015
Ownership / control type
VOLUNTARY NON PROFIT OTHER THAN CHURCH
Facility address
901 North 9TH Street Suite 100
Virginia, MN 55792

National Provider Directory

National Provider Directory

Locations

901 9th St N
Ste 100
Virginia, MN 55792
Phone (218) 749-9405

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1414022400000",
    "number": "1316098445",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 9TH ST N",
            "address_2": "SUITE 100",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922279",
            "telephone_number": "218-749-9405",
            "fax_number": "218-749-9407"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 9TH ST N",
            "address_2": "SUITE 100",
            "city": "VIRGINIA",
            "state": "MN",
            "postal_code": "557922279",
            "telephone_number": "218-749-9405",
            "fax_number": "218-749-9407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IRON RANGE REHABILITATION CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-16",
        "last_updated": "2014-10-23",
        "status": "A",
        "authorized_official_last_name": "ELLIOTT",
        "authorized_official_first_name": "ANDREW",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "218-749-9405",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "575555700",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia, MN

Sources for this page

Verify at the official NPI Registry.