Elite Rehab

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

L475728 Issued in MI

Legal business name

ELITE REHAB

Practice address

2449 E. 12 Mile
Warren, MI 48092

Phone

(586) 755-4711

Fax

(586) 755-7211

NPI assigned

Mar 15, 2006

Last updated

Nov 18, 2009By 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

Betty Gusho, PTNPI 1134311657

Title

Physical Therapist

Phone

(586) 755-4711

Specialties & licenses 2

Addresses

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Betty Kallis Gusho

  • Physical Therapist
  • Warren, MI
  • NPI 1134311657
  NPD (past) Authorized official
• Lydia Nierman Cornwall

  • Physical Therapist
  • Warren, MI
  • NPI 1548466527
  NPD (past)

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

{
    "created_epoch": "1142380800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1258502400000",
    "number": "1376512020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2449 E. 12 MILE RD.",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48092",
            "telephone_number": "586-755-4711",
            "fax_number": "586-755-7211"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2449 E. 12 MILE",
            "city": "WARREN",
            "state": "MI",
            "postal_code": "48092",
            "telephone_number": "586-755-4711",
            "fax_number": "586-755-7211"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ELITE REHAB",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-03-15",
        "last_updated": "2009-11-18",
        "status": "A",
        "authorized_official_last_name": "GUSHO",
        "authorized_official_first_name": "BETTY",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "586-755-4711",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "L475728",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MI",
            "license": "L537632",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Electrical Workers Joint Board of Trustees
• Elements of Wellness LLC
• Lisa Elia, M.S.
• Lord Ameer Elia I
• Elite Home Help Agency LLC
• Elite Technical Care LLC
• Elisheva Ellenberg
• Megan Ellery, LPC
• Dakota Elliott
• Sara Elliott, PMHNP-BC

• Physical Therapist in Warren, MI
• Providers in Warren, MI by specialty
• Physical Therapist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2009; 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.