NPIMap

Organization Active NPI

Industrial Wellness Rehab, Inc

  • Physical Therapist
  • Mobile, AL
National Provider Identifier
1437214574
Registry record updated May 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PTH1122 Issued in AL
Legal business name
INDUSTRIAL WELLNESS REHAB, INC
Practice address
2048A S Broad St
Brookley Complex
Mobile, AL 36615-1285
Phone
(251) 433-1414
Fax
(251) 433-9634
NPI assigned
Dec 27, 2006
Last updated
May 23, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 23, 2016

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

Authorized official

Name
Mrs. Lisa W Sullivan
Title
VP-Accts Receivable Manager
Phone
(251) 433-1414

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PTH1122 AL Primary
Physical Therapist 225100000X PTH1919 AL
Physical Therapist 225100000X PTH4083 AL

Addresses

Primary practice location

2048A S Broad St
Brookley Complex
Mobile, AL 36615-1285

Mailing address

2048A S Broad St
Brookley Complex
Mobile, AL 36615-1285
Phone (251) 433-1414

Other identifiers 4

IdentifierTypeStateIssuer
102I650307OtherALMEDICARE PTAN - DEBORAH NELSON - BROOKLEY
511-14905OtherALBCBS - DEBORAH NELSON - BROOKLEY LOCATION
510I650221OtherALMEDICARE PTAN - BEVERLY WILKINS PT - BROOKLEY LOCATION
510I650231OtherALMEDICARE PTAN - WILLIAM H FARNELL - BROOKLEY LOCATION

Other names 1

  • IWR Therapy Systems Other name

National Provider Directory

National Provider Directory

Locations

2048 S Broad St
Mobile, AL 36615
Phone (251) 433-1414

627 Highway 43 S
#B
Saraland, AL 36571
Phone (251) 675-3390

8020 Moffett Rd
Ste B
Semmes, AL 36575
Phone (251) 645-3708

Practitioners & affiliated clinicians

Practitioners 4

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": "1167177600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1463961600000",
    "number": "1437214574",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2048A S BROAD ST",
            "address_2": "BROOKLEY COMPLEX",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366151285",
            "telephone_number": "251-433-1414",
            "fax_number": "251-433-9634"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2048A S BROAD ST",
            "address_2": "BROOKLEY COMPLEX",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366151285",
            "telephone_number": "251-433-1414",
            "fax_number": "251-433-9634"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INDUSTRIAL WELLNESS REHAB, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-27",
        "last_updated": "2016-05-23",
        "status": "A",
        "authorized_official_last_name": "SULLIVAN",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "VP-ACCTS RECEIVABLE MANAGER",
        "authorized_official_telephone_number": "251-433-1414",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH1122",
            "primary": true
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH1919",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "AL",
            "license": "PTH4083",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN - DEBORAH NELSON - BROOKLEY",
            "identifier": "102I650307",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS - DEBORAH NELSON - BROOKLEY LOCATION",
            "identifier": "511-14905",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN - BEVERLY WILKINS PT - BROOKLEY LOCATION",
            "identifier": "510I650221",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE PTAN - WILLIAM H FARNELL - BROOKLEY LOCATION",
            "identifier": "510I650231",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IWR Therapy Systems",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Mobile, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 23, 2016; 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.