NPIMap

Organization Active NPI

Union Lake Physical Rehabilitation, LLC

  • Physical Medicine & Rehabilitation Physician
  • Commerce TWP, MI
National Provider Identifier
1437429370
Registry record updated Jan 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X
License
5501002317 Issued in MI
Legal business name
UNION LAKE PHYSICAL REHABILITATION, LLC
Practice address
2455 Union Lake Rd
Commerce TWP, MI 48382
Phone
(248) 242-6025
NPI assigned
Jan 10, 2012
Last updated
Jan 10, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 10, 2012

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

Authorized official

Name
Stefan Nedelea, PHYSICAL THERAPISTNPI 1992795181
Title
Owner/Physical Therapist
Phone
(248) 593-8677

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208100000X 5501002317 MI Primary
Physical Medicine & Rehabilitation PhysicianGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 208100000X 5501008896 MI

Addresses

Primary practice location

2455 Union Lake Rd
Commerce TWP, MI 48382

Mailing address

2455 Union Lake Rd
Commerce TWP, MI 48382

National Provider Directory

National Provider Directory

Locations

2455 Union Lake Rd
Ste 104
Commerce Twp, MI 48382
Phone (248) 242-6025

Practitioners & affiliated clinicians

Practitioners 3

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": "1326153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1326153600000",
    "number": "1437429370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2455 UNION LAKE RD",
            "city": "COMMERCE TWP",
            "state": "MI",
            "postal_code": "48382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2455 UNION LAKE RD",
            "city": "COMMERCE TWP",
            "state": "MI",
            "postal_code": "48382",
            "telephone_number": "248-242-6025"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UNION LAKE PHYSICAL REHABILITATION, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-01-10",
        "last_updated": "2012-01-10",
        "status": "A",
        "authorized_official_last_name": "NEDELEA",
        "authorized_official_first_name": "STEFAN",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPIST",
        "authorized_official_telephone_number": "248-593-8677",
        "authorized_official_credential": "PHYSICAL THERAPIST"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5501002317",
            "primary": true
        },
        {
            "code": "208100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "MI",
            "license": "5501008896",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Commerce TWP, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 10, 2012; 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.