Medical Clinic of Greensburg

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

01051524 Issued in IN

Legal business name

MEDICAL CLINIC OF GREENSBURG

Practice address

203 East North Street
Greesnburg, IN 46240

Phone

(812) 662-8699

NPI assigned

Jul 20, 2007

Last updated

Jun 23, 2008By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Mustafa Rehab, MD

Title

Owner

Phone

(812) 662-8699

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

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

{
    "created_epoch": "1184889600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214179200000",
    "number": "1457551103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 E NORTH ST",
            "city": "GREENSBURG",
            "state": "IN",
            "postal_code": "472401717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 EAST NORTH STREET",
            "city": "GREESNBURG",
            "state": "IN",
            "postal_code": "46240",
            "telephone_number": "812-662-8699"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MEDICAL CLINIC OF GREENSBURG",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-20",
        "last_updated": "2008-06-23",
        "status": "A",
        "authorized_official_last_name": "REHAB",
        "authorized_official_first_name": "MUSTAFA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "812-662-8699",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "IN",
            "license": "01051524",
            "primary": true
        },
        {
            "code": "207RA0401X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Addiction Medicine",
            "state": "IN",
            "license": "01051524",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200323770A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2008; 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.