Spence Rehabilitation Center, LLC

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

01062328A Issued in IN

Legal business name

SPENCE REHABILITATION CENTER, LLC

Practice address

9305 Calumet Ave
Suite C-1
Munster, IN 46321-2887

Phone

(574) 520-3489

NPI assigned

Nov 6, 2007

Last updated

Nov 6, 2007By 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

Dr. Michael John Spence, M.D.

Title

Member

Phone

(574) 520-3489

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1194307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194307200000",
    "number": "1356521538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5435 BUCKEYE AVE",
            "city": "PORTAGE",
            "state": "IN",
            "postal_code": "463684205",
            "telephone_number": "219-734-6573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9305 CALUMET AVE",
            "address_2": "SUITE C-1",
            "city": "MUNSTER",
            "state": "IN",
            "postal_code": "463212887",
            "telephone_number": "574-520-3489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SPENCE REHABILITATION CENTER, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-06",
        "last_updated": "2007-11-06",
        "status": "A",
        "authorized_official_last_name": "SPENCE",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "JOHN",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "574-520-3489",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "IN",
            "license": "01062328A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Munster, IN
• Providers in Munster, IN by specialty
• Physical Medicine & Rehabilitation Physician in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2007; 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.