Worksport Rehabilitation Service

Primary specialty

SpecialistTaxonomy code 174400000X

License

05002570A Issued in IN

Legal business name

WORKSPORT REHABILITATION SERVICE

Practice address

411 E Ireland Rd Ste 400
South Bend, IN 46614-2681

Phone

(574) 231-8950

Fax

(574) 231-8955

NPI assigned

Oct 6, 2006

Last updated

Aug 22, 2020By 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

Randall Brooks, RPTNPI 1184660870

Title

President/Owner

Phone

(574) 231-8950

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 2

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.

• Randall Glenn Brooks, PT

  • Physical Therapist
  • Granger, IN
  • NPI 1184660870

  Specialist

  NPD (past) Authorized official
• Robert Allen Dolata, M.P.T.

  • Physical Therapist
  • Venice, FL
  • NPI 1265483945
  NPD (past)

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1497842033",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 E IRELAND RD STE 400",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142681",
            "telephone_number": "574-231-8950",
            "fax_number": "574-231-8955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 E IRELAND RD STE 400",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466142681",
            "telephone_number": "574-231-8950",
            "fax_number": "574-231-8955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WORKSPORT REHABILITATION SERVICE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-06",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "BROOKS",
        "authorized_official_first_name": "RANDALL",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "574-231-8950",
        "authorized_official_credential": "RPT"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "IN",
            "license": "05002570A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BC BS PROVIDER NUMBER",
            "identifier": "000000093552",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• John Robert Woods, M.D.
• Donna Lynn Woodward, NP-C
• Elizabeth Ann Woolsey, PHARMD
• Ariel Words, RMA
• Michael Workman, MSN, PMHNP
• Victoria Wozniski
• Ethan Wren, D.O.
• Wright Directions Counseling Services
• Wright Dream
• Wright Dream

• Specialist in South Bend, IN
• Providers in South Bend, IN by specialty
• Specialist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; 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.