Powerback Rehabilitation LLC

Primary specialty

Rehabilitation Clinic/CenterTaxonomy code 261QR0400X

Legal business name

POWERBACK REHABILITATION LLC

Doing business as

Powerback Rehabilitation

Practice address

145 Pine Haven Shores Rd Ste 1000
Shelburne, VT 05482-7812

Phone

(802) 304-4048

NPI assigned

Jun 27, 2023

Organization subpart

No

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

Authorized official

Name

Carl Anthony Shrom

Title

Chief Executive Officer

Phone

(215) 896-0422

Specialties & licenses 1

Addresses

Other names 1

• Powerback Rehabilitation Doing business as

Tax ID family

Genesis Rehab Serv209 organizations share this tax ID, including this one

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687824000000",
    "number": "1356027080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 E STATE ST",
            "city": "KENNETT SQUARE",
            "state": "PA",
            "postal_code": "193483109",
            "telephone_number": "800-728-8808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "145 PINE HAVEN SHORES RD STE 1000",
            "city": "SHELBURNE",
            "state": "VT",
            "postal_code": "054827812",
            "telephone_number": "802-304-4048"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "POWERBACK REHABILITATION LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A",
        "authorized_official_last_name": "SHROM",
        "authorized_official_first_name": "CARL",
        "authorized_official_middle_name": "ANTHONY",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "215-896-0422"
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Powerback Rehabilitation",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pdi Health VT LLC
• Emily Bishop Pelcher, HIS
• Christine Denise Petterson, OTR
• David H Pierson, D.C.
• Thomas Powell, PH.D.
• Powerback Rehabilitation LLC (Powerback Rehabilitation)
• Stephen Powers
• Precious Steps ABA LLC
• Meagan Elizabeth Purdy, N.D.
• Puremed Primary Care PLLC

• Rehabilitation Clinic/Center in Shelburne, VT
• Providers in Shelburne, VT by specialty
• Rehabilitation Clinic/Center in Vermont

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; 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.