Organization Active NPI

Mobilitywise LLC

  • Physical Therapist
  • New Buffalo, MI
National Provider Identifier
1497453427
Registry record updated Jan 5, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MOBILITYWISE LLC
Practice address
19349 Highland Dr
New Buffalo, MI 49117-8942
Phone
(773) 823-6306
NPI assigned
Feb 20, 2023
Last updated
Jan 5, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2024

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

Authorized official

Name
Rebecca Lynn Gardner-Reilly, PTNPI 1427234749
Title
PT
Phone
(773) 824-6306

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary

Addresses

Primary practice location

19349 Highland Dr
New Buffalo, MI 49117-8942

Mailing address

19349 Highland Dr
New Buffalo, MI 49117-8942
Phone (773) 824-6306

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI, IN2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20230403001298 MI Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5799150892 Receives reassigned benefits from 1 practitioner
Practice locations: New Buffalo, MI
O20240222002686 IN Part B Supplier - Physical/Occupational Therapy Group in Private Practice 5799150892 Receives reassigned benefits from 1 practitioner
Practice locations: Michigan City, IN

National Provider Directory

National Provider Directory

Locations

200 Heisman Harbor Rd
#441
Michigan City, IN 46360
Phone (773) 824-6306

Practitioners & affiliated clinicians

Practitioners 1

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": "1676851200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1704412800000",
    "number": "1497453427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19349 HIGHLAND DR",
            "city": "NEW BUFFALO",
            "state": "MI",
            "postal_code": "491178942",
            "telephone_number": "773-824-6306"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19349 HIGHLAND DR",
            "city": "NEW BUFFALO",
            "state": "MI",
            "postal_code": "491178942",
            "telephone_number": "773-823-6306"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOBILITYWISE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-20",
        "last_updated": "2024-01-05",
        "certification_date": "2024-01-05",
        "status": "A",
        "authorized_official_last_name": "GARDNER-REILLY",
        "authorized_official_first_name": "REBECCA",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PT",
        "authorized_official_telephone_number": "773-824-6306",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Buffalo, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.