Organization Active NPI

Tbci PC

  • Rehabilitation Practitioner
  • Troy, MI
National Provider Identifier
1437228798
Registry record updated Jan 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation PractitionerTaxonomy code 225400000X
Legal business name
TBCI PC
Practice address
1059 Owendale
Troy, MI 48083
Phone
(248) 526-0110
Fax
(248) 680-9138
NPI assigned
Nov 8, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2009

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

Authorized official

Name
Dr. Thomas T Park, MD
Title
Director
Phone
(248) 526-0110

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 225400000X Primary

Addresses

Primary practice location

1059 Owendale
Troy, MI 48083

Mailing address

1059 Owendale
Troy, MI 48083
Phone (248) 526-0110

Other identifiers 1

IdentifierTypeStateIssuer
30421OtherMIBLUE CROSS

Other names 1

  • Breaking Barriers Rehab Center (BBRC) Doing business as

National Provider Directory

National Provider Directory

Locations

1059 Owendale Dr
Troy, MI 48083
Phone (248) 526-0110

NPI Registry JSON

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1233014400000",
    "number": "1437228798",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1059 OWENDALE",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48083",
            "telephone_number": "248-526-0110",
            "fax_number": "248-680-9138"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1059 OWENDALE",
            "city": "TROY",
            "state": "MI",
            "postal_code": "48083",
            "telephone_number": "248-526-0110",
            "fax_number": "248-680-9138"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TBCI PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-08",
        "last_updated": "2009-01-27",
        "status": "A",
        "authorized_official_last_name": "PARK",
        "authorized_official_first_name": "THOMAS",
        "authorized_official_middle_name": "T",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "248-526-0110",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "225400000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Rehabilitation Practitioner",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "30421",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Breaking Barriers Rehab Center (BBRC)",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Troy, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 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.