Independence Rehabilitation, Inc

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

OS012799 Issued in PA

Legal business name

INDEPENDENCE REHABILITATION, INC

Practice address

675 Good Dr
Lancaster, PA 17601-2426

Phone

(717) 406-3013

Fax

(717) 394-7501

NPI assigned

Sep 13, 2007

Last updated

Jul 21, 2022By 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

Mr. Dean Godfrey, MD

Title

Owner/Provider

Phone

(717) 406-3013

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1189641600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1376738260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 AVERY OLIVIA WAY STE C",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265549375",
            "telephone_number": "304-363-7000",
            "fax_number": "304-366-7413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "675 GOOD DR",
            "city": "LANCASTER",
            "state": "PA",
            "postal_code": "176012426",
            "telephone_number": "717-406-3013",
            "fax_number": "717-394-7501"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDEPENDENCE REHABILITATION, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-13",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "GODFREY",
        "authorized_official_first_name": "DEAN",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "717-406-3013",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "PA",
            "license": "OS012799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Physical Medicine & Rehabilitation Physician in Lancaster, PA
• Providers in Lancaster, PA by specialty
• Physical Medicine & Rehabilitation Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.