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Organization Active NPI

Orthopedic Rehab Specialists P C

  • Physical Therapist
  • Rockford, IL
National Provider Identifier
1427003318
Registry record updated Jan 28, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
060-007530 Issued in IL
Legal business name
ORTHOPEDIC REHAB SPECIALISTS P C
Practice address
2662 McFarland Rd
Rockford, IL 61107-6806
Phone
(815) 227-1700
Fax
(815) 227-1744
NPI assigned
May 23, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2014

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

Authorized official

Name
David A. Black, PT, MS, OCS
Title
Owner/Executive Officer
Phone
(815) 227-1700

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193400000X SINGLE SPECIALTY GROUP 225100000X 060-007530 IL Primary

Addresses

Primary practice location

2662 McFarland Rd
Rockford, IL 61107-6806

Mailing address

2662 McFarland Rd
Rockford, IL 61107-6806
Phone (815) 227-1700

Other identifiers 1

IdentifierTypeStateIssuer
060-007530OtherILPROFESSIONAL LICENSE

National Provider Directory

National Provider Directory

Locations

5306 Williams Dr
Roscoe, IL 61073
Phone (815) 270-0704

201 W Soper St
Winnebago, IL 61088
Phone (815) 335-1381

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1148342400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1390867200000",
    "number": "1427003318",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2662 MCFARLAND RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076806",
            "telephone_number": "815-227-1700",
            "fax_number": "815-227-1744"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2662 MCFARLAND RD",
            "city": "ROCKFORD",
            "state": "IL",
            "postal_code": "611076806",
            "telephone_number": "815-227-1700",
            "fax_number": "815-227-1744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPEDIC REHAB SPECIALISTS P C",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-05-23",
        "last_updated": "2014-01-28",
        "status": "A",
        "authorized_official_last_name": "BLACK",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A.",
        "authorized_official_title_or_position": "OWNER/EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "815-227-1700",
        "authorized_official_credential": "PT, MS, OCS"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Physical Therapist",
            "state": "IL",
            "license": "060-007530",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PROFESSIONAL LICENSE",
            "identifier": "060-007530",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockford, IL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2014; 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.