NPIMap

Organization Active NPI

Professional Rehabilitation Services, Inc.

Doing business as Rebound Home and Community Therapy

  • Physical Medicine & Rehabilitation Physician
  • Grand Rapids, MI
National Provider Identifier
1417466202
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
Legal business name
PROFESSIONAL REHABILITATION SERVICES, INC.
Doing business as
Rebound Home and Community Therapy
Rebound Physical Therapy and Occupational Therapy
Practice address
2211 E Beltline Ave NE Ste C
Grand Rapids, MI 49525-9802
Phone
(616) 202-4840
NPI assigned
Sep 25, 2017
Last updated
Mar 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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

Authorized official

Name
Mr. Kristian Skogen
Title
Ceo
Phone
(616) 202-4840

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior AnalystGroup: 193200000X MULTI-SPECIALTY GROUP 103K00000X
Physical Medicine & Rehabilitation PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208100000X Primary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X
Occupational TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225X00000X

Addresses

Primary practice location

2211 E Beltline Ave NE Ste C
Grand Rapids, MI 49525-9802

Mailing address

4234 Cascade Rd SE
Grand Rapids, MI 49546-8384
Phone (616) 464-1117

Other practice location 1

4234 Cascade Rd SE
Grand Rapids, MI 49546-8384
Phone (616) 464-1117

Other names 2

  • Rebound Home and Community Therapy Doing business as
  • Rebound Physical Therapy and Occupational Therapy Doing business as

National Provider Directory

National Provider Directory

Locations

1394 E Bristol Rd
Ste B
Burton, MI 48529
Phone (810) 658-7811

2211 E Beltline Ave NE
Grand Rapids, MI 49525
Phone (616) 202-4840

2211 E Beltline Ave NE
Ste C
Grand Rapids, MI 49525
Phone (616) 202-4840

Practitioners & affiliated clinicians

Practitioners 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1506297600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1614556800000",
    "number": "1417466202",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4234 CASCADE RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468384",
            "telephone_number": "616-464-1117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 E BELTLINE AVE NE STE C",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259802",
            "telephone_number": "616-202-4840"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4234 Cascade Rd SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495468384",
            "country_code": "US",
            "telephone_number": "616-464-1117",
            "fax_number": "616-464-1044",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "PROFESSIONAL REHABILITATION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-25",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A",
        "authorized_official_last_name": "SKOGEN",
        "authorized_official_first_name": "KRISTIAN",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "616-202-4840",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rebound Home and Community Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rebound Physical Therapy and Occupational Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2021; 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.