NPIMap

Organization Active NPI

Broad St Physical Rehab LLC

  • Chiropractor
  • Columbus, OH
National Provider Identifier
1467686121
Registry record updated Apr 7, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1689 Issued in OH
Legal business name
BROAD ST PHYSICAL REHAB LLC
Practice address
3072 W Broad St
Columbus, OH 43204-1302
Phone
(614) 725-4720
Fax
(614) 725-0787
NPI assigned
May 11, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 7, 2011

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

Authorized official

Name
Dr. Robert Cohen
Title
Member
Phone
(614) 725-4720

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 1689 OH Primary

Addresses

Primary practice location

3072 W Broad St
Columbus, OH 43204-1302

Mailing address

3072 W Broad St
Columbus, OH 43204-1302
Phone (614) 725-4720

National Provider Directory

National Provider Directory

Locations

3072 W Broad St
Columbus, OH 43204
Phone (614) 725-4720

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1242000000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1302134400000",
    "number": "1467686121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3072 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432041302",
            "telephone_number": "614-725-4720",
            "fax_number": "614-725-0787"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3072 W BROAD ST",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432041302",
            "telephone_number": "614-725-4720",
            "fax_number": "614-725-0787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BROAD ST PHYSICAL REHAB LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-05-11",
        "last_updated": "2011-04-07",
        "status": "A",
        "authorized_official_last_name": "COHEN",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "614-725-4720",
        "authorized_official_name_prefix": "Dr."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OH",
            "license": "1689",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Columbus, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2011; 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.