Organization Active NPI

Prime Rehab and Physical Therapy Inc

  • Physical Disabilities Residential Treatment Facility
  • Detroit, MI
National Provider Identifier
1457356453
Registry record updated Mar 7, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Disabilities Residential Treatment FacilityTaxonomy code 320700000X
Legal business name
PRIME REHAB AND PHYSICAL THERAPY INC
Practice address
2900 S Fort St
Ste 3
Detroit, MI 48217-1061
Phone
(313) 388-0156
Fax
(313) 388-0593
NPI assigned
Jun 16, 2005
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2012

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

Authorized official

Name
Dr. Muhammad Sadiq
Title
Administrator
Phone
(313) 357-3079

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Disabilities Residential Treatment Facility 320700000X Primary

Addresses

Primary practice location

2900 S Fort St
Ste 3
Detroit, MI 48217-1061

Mailing address

7140 W Fort St
Ste 4
Detroit, MI 48209-2917
Phone (313) 357-3079

Other identifiers 1

IdentifierTypeStateIssuer
4676467MedicaidMI

National Provider Directory

National Provider Directory

Locations

7140 W Fort St
#4
Detroit, MI 48209
Phone (313) 357-3079

7140 W Fort St
Ste 4
Detroit, MI 48209
Phone (313) 388-0510

2900 S Fort St
Ste 3
Detroit, MI 48217
Phone (313) 388-0156

NPI Registry JSON

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

{
    "created_epoch": "1118880000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331078400000",
    "number": "1457356453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7140 W FORT ST",
            "address_2": "STE 4",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482092917",
            "telephone_number": "313-357-3079",
            "fax_number": "313-388-0593"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2900 S FORT ST",
            "address_2": "STE 3",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482171061",
            "telephone_number": "313-388-0156",
            "fax_number": "313-388-0593"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIME REHAB AND PHYSICAL THERAPY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-06-16",
        "last_updated": "2012-03-07",
        "status": "A",
        "authorized_official_last_name": "SADIQ",
        "authorized_official_first_name": "MUHAMMAD",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "313-357-3079",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "320700000X",
            "taxonomy_group": "",
            "desc": "Residential Treatment Facility, Physical Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4676467",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 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.