Organization Active NPI

Pure Relief Rehab Center

  • Internal Medicine Physician
  • Warren, MI
National Provider Identifier
1336856921
Registry record updated Nov 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
PURE RELIEF REHAB CENTER
Practice address
2104 E 11 Mile Rd Ste 100
Warren, MI 48091-6121
Phone
(586) 486-5727
Fax
(586) 486-5736
NPI assigned
Nov 2, 2022
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 2, 2022

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

Authorized official

Name
Mrs. Tara King
Title
Business Owner
Phone
(313) 765-7128

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X Primary

Addresses

Primary practice location

2104 E 11 Mile Rd Ste 100
Warren, MI 48091-6121

Mailing address

2104 E 11 Mile Rd Ste 100
Warren, MI 48091-6121
Phone (586) 486-5727

National Provider Directory

National Provider Directory

Locations

2104 E 11 Mile Rd
Ste 100
Warren, MI 48091
Phone (586) 619-7840

NPI Registry JSON

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

{
    "created_epoch": "1667347200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1667347200000",
    "number": "1336856921",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2104 E 11 MILE RD STE 100",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480916121",
            "telephone_number": "586-486-5727"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2104 E 11 MILE RD STE 100",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "480916121",
            "telephone_number": "586-486-5727",
            "fax_number": "586-486-5736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PURE RELIEF REHAB CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-11-02",
        "last_updated": "2022-11-02",
        "certification_date": "2022-11-02",
        "status": "A",
        "authorized_official_last_name": "KING",
        "authorized_official_first_name": "TARA",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "313-765-7128",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Warren, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2022; 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.