NPIMap

Organization Active NPI

Herrick Medical Center Rehab

  • Rehabilitation Hospital Unit
  • Tecumseh, MI
National Provider Identifier
1346387552
Registry record updated Jul 22, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Hospital UnitTaxonomy code 273Y00000X
Legal business name
HERRICK MEDICAL CENTER REHAB
Practice address
500 E Pottawatamie St
Tecumseh, MI 49286-2018
Phone
(517) 424-3000
Fax
(517) 265-0496
NPI assigned
Jan 30, 2007
Organization subpart
Yes
Parent organization
HERRICK MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 22, 2010

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

Authorized official

Name
Tim Jakacki
Title
President
Phone
(517) 265-0900

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Hospital Unit 273Y00000X MI Primary

Addresses

Primary practice location

500 E Pottawatamie St
Tecumseh, MI 49286-2018

Mailing address

500 E Pottawatamie St
Tecumseh, MI 49286-2018
Phone (517) 424-3000

Other identifiers 6

IdentifierTypeStateIssuer
00085OtherMIBCBS
06088OtherMIPARAMOUNT
104806OtherMIPREFERRED CHOICE &CARE CH
1556080MedicaidMI
5170836MedicaidMI
H04405OtherMIM-CARE

Other names 1

  • Herrick Memorial Hospital Rehab Former legal business name

National Provider Directory

National Provider Directory
Tax ID family
James Bengston MD5 organizations share this tax ID, including this one
Part of
James Bengston MD

Other organizations with this tax ID 4

Organizations that report the same tax identification number in the National Provider Directory.

NPI Registry JSON

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1279756800000",
    "number": "1346387552",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 E POTTAWATAMIE ST",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "492862018",
            "telephone_number": "517-424-3000",
            "fax_number": "517-265-0496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 E POTTAWATAMIE ST",
            "city": "TECUMSEH",
            "state": "MI",
            "postal_code": "492862018",
            "telephone_number": "517-424-3000",
            "fax_number": "517-265-0496"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HERRICK MEDICAL CENTER REHAB",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HERRICK MEDICAL CENTER",
        "enumeration_date": "2007-01-30",
        "last_updated": "2010-07-22",
        "status": "A",
        "authorized_official_last_name": "JAKACKI",
        "authorized_official_first_name": "TIM",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "517-265-0900"
    },
    "taxonomies": [
        {
            "code": "273Y00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Unit",
            "state": "MI",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "00085",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PARAMOUNT",
            "identifier": "06088",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREFERRED CHOICE &CARE CH",
            "identifier": "104806",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1556080",
            "state": "MI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "5170836",
            "state": "MI"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "M-CARE",
            "identifier": "H04405",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Herrick Memorial Hospital Rehab",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

Other providers in Tecumseh, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 22, 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.