NPIMap

Organization Active NPI

Professional Rehabilitation Services, Inc.

  • Rehabilitation Clinic/Center
  • Grand Rapids, MI
National Provider Identifier
1508980285
Registry record updated Feb 8, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation Clinic/CenterTaxonomy code 261QR0400X
Legal business name
PROFESSIONAL REHABILITATION SERVICES, INC.
Practice address
2211 E Beltline Ave NE
Grand Rapids, MI 49525-9802
Phone
(616) 202-4840
NPI assigned
Mar 19, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 8, 2021

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

Authorized official

Name
Mr. Kristian Skogen
Title
President
Phone
(616) 202-4840

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Clinic/Center 261QR0400X Primary

Addresses

Primary practice location

2211 E Beltline Ave NE
Grand Rapids, MI 49525-9802

Mailing address

4234 Cascade Rd SE
Grand Rapids, MI 49546-8384
Phone (616) 202-4840

Other identifiers 1

IdentifierTypeStateIssuer
30664OtherMIBLUE CROSS BLUESHEILD OF

Other names 1

  • Rebound Physical Therapy & Occupational Therapy Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 7

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": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612742400000",
    "number": "1508980285",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4234 CASCADE RD SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468384",
            "telephone_number": "616-202-4840",
            "fax_number": "888-371-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2211 E BELTLINE AVE NE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259802",
            "telephone_number": "616-202-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PROFESSIONAL REHABILITATION SERVICES, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2021-02-08",
        "certification_date": "2021-02-05",
        "status": "A",
        "authorized_official_last_name": "SKOGEN",
        "authorized_official_first_name": "KRISTIAN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "616-202-4840",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QR0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUESHEILD OF",
            "identifier": "30664",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Rebound Physical Therapy & Occupational Therapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Rebound Physical Therapy & Occupational Therapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Grand Rapids, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 8, 2021; 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.