Advanced Rehabilitation Service

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

License

IT3229 Issued in NM

Legal business name

ADVANCED REHABILITATION SERVICE

Practice address

4001 Juan Tabo Blvd NE Ste B
Albuquerque, NM 87111-3979

Phone

(505) 299-2521

Fax

(505) 298-8899

NPI assigned

Jul 5, 2006

Last updated

Jul 29, 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

Miss Danielle Lynn Thiesen

Title

Ceo

Phone

(505) 299-2521

Specialties & licenses 1

Addresses

Other identifiers 1

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

{
    "created_epoch": "1152057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217289600000",
    "number": "1316977085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 JUAN TABO PLACE NE SUITE B",
            "city": "ALBUQUERQNE",
            "state": "NM",
            "postal_code": "87111",
            "telephone_number": "505-299-2521",
            "fax_number": "505-298-8899"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4001 JUAN TABO BLVD NE STE B",
            "city": "ALBUQUERQUE",
            "state": "NM",
            "postal_code": "871113979",
            "telephone_number": "505-299-2521",
            "fax_number": "505-298-8899"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ADVANCED REHABILITATION SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-05",
        "last_updated": "2008-07-29",
        "status": "A",
        "authorized_official_last_name": "THIESEN",
        "authorized_official_first_name": "DANIELLE",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "505-299-2521",
        "authorized_official_name_prefix": "Miss"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": "NM",
            "license": "IT3229",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "31536859",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Advanced Pain and Neurology, LLC
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• Advanced Vascular LLC (Advanced Vascular)
• Advantage Communication Systems, Inc.
• Advantage Dental Care
• Advantage Home Care Inc. (Corus Health)

• Rehabilitation Clinic/Center in Albuquerque, NM
• Providers in Albuquerque, NM by specialty
• Rehabilitation Clinic/Center in New Mexico

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 29, 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.